Provider Demographics
NPI:1821037524
Name:PATEL, VANDANA K (MD)
Entity Type:Individual
Prefix:DR
First Name:VANDANA
Middle Name:K
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 E 7TH ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-4398
Mailing Address - Country:US
Mailing Address - Phone:704-372-7900
Mailing Address - Fax:704-376-2216
Practice Address - Street 1:2600 E 7TH ST UNIT A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-4398
Practice Address - Country:US
Practice Address - Phone:704-372-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-00693207K00000X, 207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00218434OtherR.R. MEDICARE
TX3548585OtherAETNA HMO
TX4236709OtherBLUE LINK
TX7769270OtherAETNA PPO
TX159535701Medicaid
TX3548585OtherAETNA HMO
TX7769270OtherAETNA PPO