Provider Demographics
NPI:1932192481
Name:PATEL, RAJESHKUMAR M (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJESHKUMAR
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAJ
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:724 ARDEN LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2984
Mailing Address - Country:US
Mailing Address - Phone:803-980-7337
Mailing Address - Fax:803-980-2229
Practice Address - Street 1:724 ARDEN LN
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2984
Practice Address - Country:US
Practice Address - Phone:803-980-7337
Practice Address - Fax:803-980-2229
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23414208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT76806Medicaid