MEDICARE: DR. SWETANG M PATEL MD

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	207Q00000X	Family Medicine Physician	2006-00567	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	204973421	OTHER	NC	207Q00000X

General Provider Information

NPI Number	:	1164436606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SWETANG M PATEL MD

Provider Business Mailing Address
First Line	:	2587 HENDERSON DR
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-5253
Country	:	US
Telephone Number	:	910-938-3200
Fax Number	:	910-938-3043

Provider Business Practice Location Address
First Line	:	2587 HENDERSON DR
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-5253
Country	:	US
Telephone Number	:	910-938-3200
Fax Number	:	910-938-3043

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

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	05/06/2008

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