Provider Demographics
NPI:1376627265
Name:PATKAR, ASHWIN (MD)
Entity Type:Individual
Prefix:
First Name:ASHWIN
Middle Name:
Last Name:PATKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 BELLES LANDING CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-9797
Mailing Address - Country:US
Mailing Address - Phone:215-292-5183
Mailing Address - Fax:
Practice Address - Street 1:7850 BRIER CREEK PKWY STE 102
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-8900
Practice Address - Country:US
Practice Address - Phone:919-748-4878
Practice Address - Fax:919-748-4876
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2004-0003962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2492761Medicare ID - Type Unspecified
NC89137N8Medicare ID - Type Unspecified
G64148Medicare ID - Type Unspecified