Provider Demographics
NPI:1578675104
Name:PATEL, KASHYAP B (MD)
Entity Type:Individual
Prefix:DR
First Name:KASHYAP
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1583 HEALTH CARE DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3858
Mailing Address - Country:US
Mailing Address - Phone:803-329-7772
Mailing Address - Fax:803-329-9821
Practice Address - Street 1:1583 HEALTH CARE DR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3858
Practice Address - Country:US
Practice Address - Phone:803-329-7772
Practice Address - Fax:803-329-9821
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC 22998207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC229988Medicaid
SCH575637834Medicare PIN
SCH57563Medicare UPIN