Provider Demographics
NPI:1659729184
Name:PATEL, ANKITKUMAR BIPINBHAI (MD)
Entity Type:Individual
Prefix:
First Name:ANKITKUMAR
Middle Name:BIPINBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 CAMERON VALLEY PKWY STE 3100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-4377
Mailing Address - Country:US
Mailing Address - Phone:704-355-5118
Mailing Address - Fax:704-446-1125
Practice Address - Street 1:4525 CAMERON VALLEY PKWY STE 3100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-4377
Practice Address - Country:US
Practice Address - Phone:704-355-5118
Practice Address - Fax:704-446-1125
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXS2140207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX400529001Medicaid