Healthcare Provider Details

I. General information

NPI: 1720376643
Provider Name (Legal Business Name): CHIRAG ASHOK PATEL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2011
Last Update Date: 07/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5311 N ROXBORO RD
DURHAM NC
27712-2227
US

IV. Provider business mailing address

8719 HARPS MILL RD
RALEIGH NC
27615-3887
US

V. Phone/Fax

Practice location:
  • Phone: 919-471-4409
  • Fax:
Mailing address:
  • Phone: 919-559-6549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21920
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: