Provider Demographics
NPI:1689766198
Name:PATEL, BHARATKUMAR MADHUSUDANBHAI (PHARMD)
Entity Type:Individual
Prefix:
First Name:BHARATKUMAR
Middle Name:MADHUSUDANBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 ACADEMY DRIVE
Mailing Address - Street 2:APT. 107
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-1882
Mailing Address - Country:US
Mailing Address - Phone:334-501-0737
Mailing Address - Fax:
Practice Address - Street 1:2400 HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:TUSKEGEE
Practice Address - State:AL
Practice Address - Zip Code:36083
Practice Address - Country:US
Practice Address - Phone:334-727-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14989183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist