Provider Demographics
NPI:1184497208
Name:PATEL, DILLAN
Entity type:Individual
Prefix:
First Name:DILLAN
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3786 CENTRAL PIKE STE 120
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3498
Mailing Address - Country:US
Mailing Address - Phone:615-454-3300
Mailing Address - Fax:615-454-3305
Practice Address - Street 1:3786 CENTRAL PIKE STE 120
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3498
Practice Address - Country:US
Practice Address - Phone:615-454-3300
Practice Address - Fax:615-454-3305
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42666183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist