Provider Demographics
NPI:1417944885
Name:PATEL, HIREN R (MD)
Entity Type:Individual
Prefix:DR
First Name:HIREN
Middle Name:R
Last Name:PATEL
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 1:3009 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2984
Mailing Address - Country:US
Mailing Address - Phone:910-739-9227
Mailing Address - Fax:910-738-6137
Practice Address - Street 1:3009 N ELM ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2984
Practice Address - Country:US
Practice Address - Phone:910-739-9227
Practice Address - Fax:910-738-6137
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC65801OtherBLUE CROSS BLUE SHIELD
NC2205078AOtherMEDICARE-ID/INDIVIDUAL
NC8965801Medicaid
F93277Medicare UPIN