Provider Demographics
NPI:1902830052
Name:PATTERSON, PATTI J (MD)
Entity Type:Individual
Prefix:DR
First Name:PATTI
Middle Name:J
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2000 E GREENVILLE ST
Mailing Address - Street 2:SUITE 2800
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1580
Mailing Address - Country:US
Mailing Address - Phone:864-226-7636
Mailing Address - Fax:864-231-7743
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:SUITE 2800
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-226-7636
Practice Address - Fax:864-231-7743
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC05902084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTL2654Medicaid
SCTL2654Medicaid
SC2083Medicare PIN
SCAA99727111Medicare PIN