Healthcare Provider Details

I. General information

NPI: 1841476660
Provider Name (Legal Business Name): SARIKA PATEL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2008
Last Update Date: 09/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 BRAEBURN DR
SALEM VA
24153-7357
US

IV. Provider business mailing address

1970 ROANOKE BLVD SALEM VA MEDICAL CENTER
SALEM VA
24153
US

V. Phone/Fax

Practice location:
  • Phone: 540-772-3485
  • Fax: 540-772-3486
Mailing address:
  • Phone: 540-855-5059
  • Fax: 540-855-3469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110003031
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number011810
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: