MEDICARE: ARCHI MANISHBHAI PATEL PA-C

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	363A00000X	Physician Assistant	0010-15563	NC

General Provider Information

NPI Number	:	1891394714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARCHI MANISHBHAI PATEL PA-C

Provider Business Mailing Address
First Line	:	299 ASTER BLOOM LN
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-8045
Country	:	US
Telephone Number	:	570-346-3686
Fax Number	:

Provider Business Practice Location Address
First Line	:	7200 CREEDMOOR RD STE 200
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27613-1711
Country	:	US
Telephone Number	:	919-912-5600
Fax Number	:

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

Provider Enumeration Date	:	10/21/2020
Last Update Date	:	10/21/2025

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