Healthcare Provider Details
I. General information
NPI: 1689932816
Provider Name (Legal Business Name): ANKUR S PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/25/2012
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9900 POPLAR TENT RD STE 115
CONCORD NC
28027-9505
US
IV. Provider business mailing address
9900 POPLAR TENT RD SUITE 115 PMB 3006
CONCORD NC
28027-9505
US
V. Phone/Fax
- Phone: 908-380-6892
- Fax:
- Phone: 908-380-6892
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | MD457460 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | MD457460 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: