Provider Demographics
NPI:1457830259
Name:PATEL, ANKIT PARESH (PHARMD,MBA)
Entity Type:Individual
Prefix:
First Name:ANKIT
Middle Name:PARESH
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD,MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 N ELM ST APT 3H
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-2876
Mailing Address - Country:US
Mailing Address - Phone:912-224-8883
Mailing Address - Fax:
Practice Address - Street 1:4310 W WENDOVER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1911
Practice Address - Country:US
Practice Address - Phone:336-294-0335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27877183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist