Provider Demographics
NPI:1720661143
Name:PATEL, BHUMIKA NILAY
Entity Type:Individual
Prefix:
First Name:BHUMIKA
Middle Name:NILAY
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13430 HOOVER CREEK BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-0054
Mailing Address - Country:US
Mailing Address - Phone:704-910-8380
Mailing Address - Fax:
Practice Address - Street 1:13430 HOOVER CREEK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-0054
Practice Address - Country:US
Practice Address - Phone:704-910-8380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014362363L00000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery