Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 121946 | NC |
N | 111NI0900X | Internist | 121946 | NC |
Y | 207RN0300X | Nephrologist | 278088 | NC |
NPI | 1013034727 |
---|---|
Provider Name | Dr. Jay Krishnavadan Patel |
First Address | Greensboro, NC 27405-3654 |
Second Address | Greensboro, NC 27405-3654 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 09/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
56-1274347 | CAROLINA KIDNEY'S TAX ID (01) | NC |
5908623 | (05) | NC |
P00905301 | RAILROAD MEDICARE (01) | NC |