Provider Demographics
NPI:1942769666
Name:PATEL, DHARTI BHAVIN (NP-C)
Entity Type:Individual
Prefix:
First Name:DHARTI
Middle Name:BHAVIN
Last Name:PATEL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:DHARTI
Other - Middle Name:BHAVIN
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 100174
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-3174
Mailing Address - Country:US
Mailing Address - Phone:864-224-2465
Mailing Address - Fax:
Practice Address - Street 1:1800 TREE LN STE 250
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6799
Practice Address - Country:US
Practice Address - Phone:770-736-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22663363LF0000X
GARN218373363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily