Healthcare Provider Details

I. General information

NPI: 1780687426
Provider Name (Legal Business Name): NEHALI D PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/25/2005
Last Update Date: 07/13/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ST. JUDE CHILDREN'S RESEARCH HOSPITAL 332 N LAUDERDALE ST., MS 0515
MEMPHIS TN
38105-2794
US

IV. Provider business mailing address

262 DANNY THOMAS PL
MEMPHIS TN
38105-3678
US

V. Phone/Fax

Practice location:
  • Phone: 901-495-3006
  • Fax: 901-495-3842
Mailing address:
  • Phone: 901-595-3006
  • Fax: 901-595-3842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34310
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: