Healthcare Provider Details

I. General information

NPI: 1285329946
Provider Name (Legal Business Name): MAULIK MITUL PATEL PHARM. D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 MASON FARM RD
CHAPEL HILL NC
27514-5307
US

IV. Provider business mailing address

2033 TRIDENT MAPLE LN
CHAPEL HILL NC
27517-4118
US

V. Phone/Fax

Practice location:
  • Phone: 919-962-5256
  • Fax:
Mailing address:
  • Phone: 631-398-7678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835N0905X
TaxonomyNuclear Pharmacist
License Number31322
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1835N0905X
TaxonomyNuclear Pharmacist
License Number43434
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code1835N0905X
TaxonomyNuclear Pharmacist
License Number033350
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: