Provider Demographics
NPI:1467657866
Name:PATEL, NARENDRA MAFABHAI (MD, MPH)
Entity Type:Individual
Prefix:
First Name:NARENDRA
Middle Name:MAFABHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 KOGER BLVD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-2736
Mailing Address - Country:US
Mailing Address - Phone:336-485-4900
Mailing Address - Fax:336-485-4933
Practice Address - Street 1:4900 KOGER BLVD
Practice Address - Street 2:SUITE 125
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-2736
Practice Address - Country:US
Practice Address - Phone:336-485-4900
Practice Address - Fax:336-485-4933
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA37269207W00000X
NC2015-00164207W00000X
SC32113207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA70102OtherWELLMARK BCBS
IAI20508Medicare PIN
IA70102OtherWELLMARK BCBS