=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982936522
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NIMESH R. PATEL M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/08/2010
-----------------------------------------------------
Last Update Date | 11/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4001 E NC 54 HWY ASSEMBLY SUITE 1100
-----------------------------------------------------
City | DURHAM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 833-464-7245
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4001 E NC 54 HWY ASSEMBLY SUITE 1100
-----------------------------------------------------
City | DURHAM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 833-464-7245
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207ZP0102X
-----------------------------------------------------
Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
-----------------------------------------------------
License Number | MD447746
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207ZP0007X
-----------------------------------------------------
Taxonomy Name | Molecular Genetic Pathology (Pathology) Physician
-----------------------------------------------------
License Number | C196586
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207ZP0102X
-----------------------------------------------------
Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
-----------------------------------------------------
License Number | MD15093
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 207ZP0102X
-----------------------------------------------------
Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
-----------------------------------------------------
License Number | BP10034558
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 207ZP0007X
-----------------------------------------------------
Taxonomy Name | Molecular Genetic Pathology (Pathology) Physician
-----------------------------------------------------
License Number | 290553
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
Taxonomy Code | 207ZP0007X
-----------------------------------------------------
Taxonomy Name | Molecular Genetic Pathology (Pathology) Physician
-----------------------------------------------------
License Number | 306220
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
Taxonomy Code | 207ZP0007X
-----------------------------------------------------
Taxonomy Name | Molecular Genetic Pathology (Pathology) Physician
-----------------------------------------------------
License Number | BP20047685
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------