Provider Demographics
NPI:1598439168
Name:PATEL, MEGHA JITESHKUMAR
Entity Type:Individual
Prefix:
First Name:MEGHA
Middle Name:JITESHKUMAR
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 1:8265 ZODIAC LN
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-3673
Mailing Address - Country:US
Mailing Address - Phone:203-543-9204
Mailing Address - Fax:
Practice Address - Street 1:1185 DOLLY PARTON PKWY
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-3727
Practice Address - Country:US
Practice Address - Phone:865-280-6113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2023-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0015645183500000X
TN46963183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist