Basic Information
Provider Information
NPI: 1790281632
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: ABHAY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 611 MOCKSVILLE AVE
Address2:  
City: SALISBURY
State: NC
PostalCode: 281442786
CountryCode: US
TelephoneNumber: 7046337220
FaxNumber: 7046470515
Practice Location
Address1: 55 ARCH ST STE 1B
Address2:  
City: AKRON
State: OH
PostalCode: 443041436
CountryCode: US
TelephoneNumber: 3303753315
FaxNumber: 3303757779
Other Information
ProviderEnumerationDate: 03/31/2018
LastUpdateDate: 08/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
208M00000X202100542NCY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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