Provider Demographics
NPI:1811334824
Name:PATEL, TEJAL (LAC, DIPL OM, MSOM)
Entity type:Individual
Prefix:
First Name:TEJAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:LAC, DIPL OM, MSOM
Other - Prefix:
Other - First Name:TEJAL
Other - Middle Name:
Other - Last Name:AMIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8410 FALLS OF NEUSE RD STE B
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3536
Mailing Address - Country:US
Mailing Address - Phone:919-390-1550
Mailing Address - Fax:888-375-2988
Practice Address - Street 1:8410 FALLS OF NEUSE RD STE B
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3536
Practice Address - Country:US
Practice Address - Phone:919-390-1550
Practice Address - Fax:888-375-2988
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5856171100000X
NC2095171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14231129OtherCAQH