Provider Demographics
NPI:1518567288
Name:PATEL, KALPNABEN MUKESH
Entity Type:Individual
Prefix:MRS
First Name:KALPNABEN
Middle Name:MUKESH
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15311 KWANZAN CT
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-4702
Mailing Address - Country:US
Mailing Address - Phone:301-926-8220
Mailing Address - Fax:
Practice Address - Street 1:15311 KWANZAN CT
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-4702
Practice Address - Country:US
Practice Address - Phone:301-926-8220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD119081835P0200X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0200XPharmacy Service ProvidersPharmacistPediatrics