Provider Demographics
NPI:1346431004
Name:PATEL, AMIT AJITKUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:AJITKUMAR
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6729 FALLS OF NEUSE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5287
Mailing Address - Country:US
Mailing Address - Phone:919-844-6218
Mailing Address - Fax:919-847-5699
Practice Address - Street 1:6729 FALLS OF NEUSE RD STE 201
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5287
Practice Address - Country:US
Practice Address - Phone:919-844-6218
Practice Address - Fax:919-847-5699
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2021-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-01685207R00000X, 208M00000X, 207RE0101X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC150WMOtherBC/BS
NC5910585Medicaid
NC2023088Medicare PIN