Healthcare Provider Details

I. General information

NPI: 1265960520
Provider Name (Legal Business Name): BIANCA YOGESH PATEL M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6331 CARMEL RD STE 102
CHARLOTTE NC
28226-8286
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 704-316-2354
  • Fax: 704-316-2357
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2020-04387
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: