Provider Demographics
NPI:1508873266
Name:PATEL, DIPIKA P (PA)
Entity Type:Individual
Prefix:MRS
First Name:DIPIKA
Middle Name:P
Last Name:PATEL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:130 PERPETUAL SQ
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1713
Mailing Address - Country:US
Mailing Address - Phone:864-224-8689
Mailing Address - Fax:864-222-1303
Practice Address - Street 1:130 PERPETUAL SQ
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1713
Practice Address - Country:US
Practice Address - Phone:864-224-8689
Practice Address - Fax:864-222-1303
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC538363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S66388Medicare UPIN