Provider Demographics
NPI:1811476948
Name:PATEL, NIKITA N (ND)
Entity type:Individual
Prefix:
First Name:NIKITA
Middle Name:N
Last Name:PATEL
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6911 NORWOOD FRY
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6239
Mailing Address - Country:US
Mailing Address - Phone:410-917-5528
Mailing Address - Fax:
Practice Address - Street 1:5500 KNOLL NORTH DR STE 245
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2475
Practice Address - Country:US
Practice Address - Phone:410-917-5528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDJ00045175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath