MEDICARE: DR. VIRAJ MAYUR PATEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	2022-01293	NC

General Provider Information

NPI Number	:	1083146450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIRAJ MAYUR PATEL M.D.

Provider Business Mailing Address
First Line	:	3906 WAKE FOREST RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-6867
Country	:	US
Telephone Number	:	919-766-8989
Fax Number	:	919-766-8896

Provider Business Practice Location Address
First Line	:	3906 WAKE FOREST RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-6867
Country	:	US
Telephone Number	:	919-766-8989
Fax Number	:	919-766-8896

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2017
Last Update Date	:	05/24/2024

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