Provider Demographics
NPI:1932384955
Name:PATEL, AMISH V (MD)
Entity Type:Individual
Prefix:DR
First Name:AMISH
Middle Name:V
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 18563
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27619-8563
Mailing Address - Country:US
Mailing Address - Phone:919-782-1806
Mailing Address - Fax:919-782-4756
Practice Address - Street 1:3521 HAWORTH DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7244
Practice Address - Country:US
Practice Address - Phone:919-782-1806
Practice Address - Fax:919-782-4756
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036131956207Q00000X
NC2022-00800207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine