MEDICARE: DR. AMIT AJITKUMAR PATEL M.D.

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	207R00000X	Internal Medicine Physician	2008-01685	NC
2	208M00000X	Hospitalist Physician	2008-01685	NC
3	390200000X	Student in an Organized Health Care Education/Training Program
4	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	2008-01685	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	150WM	OTHER	NC	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346431004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMIT AJITKUMAR PATEL M.D.

Provider Business Mailing Address
First Line	:	6729 FALLS OF NEUSE RD STE 201
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-5287
Country	:	US
Telephone Number	:	919-844-6218
Fax Number	:	919-847-5699

Provider Business Practice Location Address
First Line	:	6729 FALLS OF NEUSE RD STE 201
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-5287
Country	:	US
Telephone Number	:	919-844-6218
Fax Number	:	919-847-5699

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

Provider Enumeration Date	:	08/07/2007
Last Update Date	:	03/27/2021

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