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General NPI Number Information
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NPI Number | 1851559454
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Entity Type | Individual
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Provider Name | NICK ROHIT PATEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 4003 COLLEGE AVE SUITE B
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City | BLUEFIELD
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State | VA
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Zip | 24605-2043
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Country | US
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Telephone | 276-322-2085
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Fax |
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Provider Business Mailing Address
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Address Line | 140 BAREFOOT LANDING DR
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City | BLOUNTVILLE
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State | TN
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Zip | 37617-5966
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Country | US
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Telephone | 352-216-7617
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101249940
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License Number State | VA
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