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NPI Code Detail

MEDICARE: VAISHALI PATEL PA

MEDICARE: VAISHALI PATEL PA
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
1390200000XStudent in an Organized Health Care Education/Training Program
2363A00000XPhysician Assistant

General Provider Information

NPI Number : 1366021230
Entity Type Code : Individual
Provider Name (Legal Business Name) : VAISHALI PATEL PA
Provider Business Mailing Address
First Line : 702 S CUMBERLAND ST
Second Line :
City : LEBANON
State : TN
Zip : 37087-4110
Country : US
Telephone Number : 615-444-2121
Fax Number :
Provider Business Practice Location Address
First Line : 702 S CUMBERLAND ST
Second Line :
City : LEBANON
State : TN
Zip : 37087-4110
Country : US
Telephone Number : 615-444-2121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2021
Last Update Date : 09/12/2022

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Directions to “ VAISHALI PATEL PA” Practice Location

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