Healthcare Provider Details

I. General information

NPI: 1588588347
Provider Name (Legal Business Name): INTEGRA MEDICAL PARTNERS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1795 DR FRANK GASTON BLVD
ROCK HILL SC
29732-1190
US

IV. Provider business mailing address

1505 FUNNY CIDE DR
WAXHAW NC
28173-7258
US

V. Phone/Fax

Practice location:
  • Phone: 839-400-4440
  • Fax: 980-246-2500
Mailing address:
  • Phone: 839-400-4440
  • Fax: 980-246-2500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: JAVED PATKA
Title or Position: OWNER
Credential: DO
Phone: 839-400-4440