Provider Demographics
NPI:1518243393
Name:PATEL, VARSHAL M
Entity Type:Individual
Prefix:
First Name:VARSHAL
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1523 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-2821
Mailing Address - Country:US
Mailing Address - Phone:919-663-2040
Mailing Address - Fax:919-663-3027
Practice Address - Street 1:1523 E 11TH ST
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-2821
Practice Address - Country:US
Practice Address - Phone:919-663-2040
Practice Address - Fax:919-663-3027
Is Sole Proprietor?:No
Enumeration Date:2011-10-25
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035048183500000X
NC25797183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist