Provider Demographics
NPI:1477992063
Name:PATEL, NEIL GHANSHYAM (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:GHANSHYAM
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-8696
Mailing Address - Fax:704-384-8697
Practice Address - Street 1:2801 RANDOLPH RD STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1051
Practice Address - Country:US
Practice Address - Phone:704-384-8696
Practice Address - Fax:704-384-8697
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL358022084N0400X
NC2018-019602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology