Provider Demographics
NPI:1275632945
Name:PATEL, CHAITANY R (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAITANY
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:107 HYANNIS DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-8336
Mailing Address - Country:US
Mailing Address - Phone:919-363-8666
Mailing Address - Fax:919-363-8668
Practice Address - Street 1:107 HYANNIS DR
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-8336
Practice Address - Country:US
Practice Address - Phone:919-363-8666
Practice Address - Fax:919-363-8668
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200601175207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1457531790OtherTRICITY FAMILY MEDICINE GROUP NPI
NC200601175OtherLICENSE
NC1881987691OtherTRICITY FAMILY MEDICINE GROUP BCBS COMMERCIAL NPI