Healthcare Provider Details

I. General information

NPI: 1578074043
Provider Name (Legal Business Name): EKTA PATEL PACHOLEC PA, MMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2017
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 N CENTER ST
HICKORY NC
28601-3760
US

IV. Provider business mailing address

1202 N CENTER ST
HICKORY NC
28601-3760
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-4340
  • Fax: 828-323-8450
Mailing address:
  • Phone: 828-322-4340
  • Fax: 828-323-8450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-12191
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: