Basic Information
Provider Information
NPI: 1013361567
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: SWAPNA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M. D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1155 MILL ST # W11
Address2:  
City: RENO
State: NV
PostalCode: 895021576
CountryCode: US
TelephoneNumber: 7753275174
FaxNumber: 7753275178
Practice Location
Address1: 800 W MEETING ST
Address2:  
City: LANCASTER
State: SC
PostalCode: 297202202
CountryCode: US
TelephoneNumber: 8032861310
FaxNumber: 8033133126
Other Information
ProviderEnumerationDate: 04/21/2016
LastUpdateDate: 07/16/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/16/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X83027SCY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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