Provider Demographics
NPI:1851421390
Name:DAVE, MEENA PATEL (PHYSICIANS ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:MEENA
Middle Name:PATEL
Last Name:DAVE
Suffix:
Gender:F
Credentials:PHYSICIANS ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 KALVESTA DRIVE
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560
Mailing Address - Country:US
Mailing Address - Phone:919-656-4905
Mailing Address - Fax:
Practice Address - Street 1:350 PINE STATE ST
Practice Address - Street 2:
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-9428
Practice Address - Country:US
Practice Address - Phone:910-893-9700
Practice Address - Fax:910-893-9747
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101946363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC101946OtherPA LICENSE #