Healthcare Provider Details

I. General information

NPI: 1194549535
Provider Name (Legal Business Name): DHRUVI PATEL PA-STUDENT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2024
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 UNIVERSITY PARK DR
NASHVILLE TN
37204-3956
US

IV. Provider business mailing address

14320 MEZZALUNA BLVD APT 222
OKLAHOMA CITY OK
73134-5079
US

V. Phone/Fax

Practice location:
  • Phone: 615-966-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: