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NPI Code Detail

MEDICARE: MRS. SIDDHI KIRITKUMAR PATEL P.A.

MEDICARE: MRS. SIDDHI KIRITKUMAR PATEL P.A.
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
1363AS0400XSurgical Physician AssistantNC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1E1955OTHERNCMEDCOST PROVIDER ID #

General Provider Information

NPI Number : 1336103225
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SIDDHI KIRITKUMAR PATEL P.A.
Provider Business Mailing Address
First Line : PO BOX 36351
Second Line :
City : CHARLOTTE
State : NC
Zip : 28236-6351
Country : US
Telephone Number : 704-377-5772
Fax Number : 704-377-3389
Provider Business Practice Location Address
First Line : 16455 STATESVILLE RD
Second Line : SUITE 310
City : HUNTERSVILLE
State : NC
Zip : 28078-7135
Country : US
Telephone Number : 704-892-8585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2006
Last Update Date : 07/08/2007

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