MEDICARE: SMITA N PATEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5925	NC

General Provider Information

NPI Number	:	1316299233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SMITA N PATEL

Provider Business Mailing Address
First Line	:	4 RIDGE GROVE CT
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-1527
Country	:	US
Telephone Number	:	336-545-1610
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 RIDGE GROVE CT
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-1527
Country	:	US
Telephone Number	:	336-545-1610
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2012
Last Update Date	:	10/03/2012

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Directions to “ SMITA N PATEL ” Practice Location

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