Provider Demographics
NPI:1912302993
Name:PATEL, HEMAL
Entity Type:Individual
Prefix:
First Name:HEMAL
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 1:5335 CENTRAL AVENUE PIKE # 412
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-3544
Mailing Address - Country:US
Mailing Address - Phone:908-247-0073
Mailing Address - Fax:
Practice Address - Street 1:5335 CENTRAL AVENUE PIKE # 412
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-3544
Practice Address - Country:US
Practice Address - Phone:908-247-0073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000038739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000038739OtherTN PHARMACY BOARD