Provider Demographics
NPI:1154686400
Name:PATEL, NIKUNJ BHARAT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NIKUNJ
Middle Name:BHARAT
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664A PORTLAND ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-2220
Mailing Address - Country:US
Mailing Address - Phone:410-251-9980
Mailing Address - Fax:
Practice Address - Street 1:664A PORTLAND ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-2220
Practice Address - Country:US
Practice Address - Phone:410-251-9980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20673183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist