Provider Demographics
NPI:1851559454
Name:PATEL, NICK ROHIT (MD)
Entity Type:Individual
Prefix:DR
First Name:NICK
Middle Name:ROHIT
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 1:140 BAREFOOT LANDING DR
Mailing Address - Street 2:
Mailing Address - City:BLOUNTVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37617-5966
Mailing Address - Country:US
Mailing Address - Phone:352-216-7617
Mailing Address - Fax:
Practice Address - Street 1:4003 COLLEGE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605-2043
Practice Address - Country:US
Practice Address - Phone:276-322-2085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101249940207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine