Provider Demographics
NPI:1235236688
Name:PATEL, AMEE (OD)
Entity Type:Individual
Prefix:DR
First Name:AMEE
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 SPRUCE MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:27592-8312
Mailing Address - Country:US
Mailing Address - Phone:919-762-0777
Mailing Address - Fax:
Practice Address - Street 1:1002 N SPENCE AVE
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4270
Practice Address - Country:US
Practice Address - Phone:919-751-5864
Practice Address - Fax:919-759-2909
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001559152W00000X
NJ27OA00592700152W00000X
NC2136152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC2172AMedicare PIN