Provider Demographics
NPI:1174036222
Name:PATEL, DHRUVANG JAGDISHBHAI (MBBS, SA-C)
Entity Type:Individual
Prefix:MR
First Name:DHRUVANG
Middle Name:JAGDISHBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MBBS, SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
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Mailing Address - Street 1:6880 RIVERS AVE UNIT 1321
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-4887
Mailing Address - Country:US
Mailing Address - Phone:706-718-4585
Mailing Address - Fax:
Practice Address - Street 1:109 BEE ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-5703
Practice Address - Country:US
Practice Address - Phone:843-789-6012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate
No1744R1103XOther Service ProvidersSpecialistResearch Data Abstracter/Coder
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program