Healthcare Provider Details

I. General information

NPI: 1770997108
Provider Name (Legal Business Name): NIMIT NAKUL PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 05/05/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 MEDICAL PARK, STE 420 NEUROLOGY DEPT
COLUMBIA SC
29203
US

IV. Provider business mailing address

8 MEDICAL PARK, STE 420 NEUROLOGY DEPT
COLUMBIA SC
29203
US

V. Phone/Fax

Practice location:
  • Phone: 803-545-6050
  • Fax: 803-545-6051
Mailing address:
  • Phone: 803-545-6050
  • Fax: 803-545-6051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2019-02689
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberE-15818
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberLL37138
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: