Healthcare Provider Details

I. General information

NPI: 1477180875
Provider Name (Legal Business Name): CHIRAG KAMLESH PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2909 HORSE PEN CREEK ROA SUITE 400
GREENSBORO NC
27413-9998
US

IV. Provider business mailing address

MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-0001
US

V. Phone/Fax

Practice location:
  • Phone: 336-702-0400
  • Fax: 336-702-0598
Mailing address:
  • Phone: 336-702-0400
  • Fax: 336-702-0598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number260847
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number2023-01580
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: