Healthcare Provider Details

I. General information

NPI: 1821901174
Provider Name (Legal Business Name): MOGRA MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 EXPOSITION PL STE 106
RALEIGH NC
27615-3356
US

IV. Provider business mailing address

701 EXPOSITION PL STE 106
RALEIGH NC
27615-3356
US

V. Phone/Fax

Practice location:
  • Phone: 931-922-1308
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DARSHANA PATEL
Title or Position: OWNER/PROVIDER
Credential: PA
Phone: 931-922-1308