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General NPI Number Information
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NPI Number | 1326412131
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Entity Type | Individual
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Provider Name | BHAVESH RAMESHBHAI PATEL
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Gender | Male
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | 1120 S CENTRAL AVE
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City | LAUREL
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State | DE
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Zip | 19956-1418
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Country | US
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Telephone | 443-519-8496
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Fax |
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Provider Business Mailing Address
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Address Line | 5222 MORNING DOVE WAY
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City | PERRY HALL
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State | MD
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Zip | 21128-8972
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Country | US
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Telephone | 443-519-8496
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | A1-0004802
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 23735
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License Number State | MD
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