Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | T-2998 | MS |
N | 111NI0900X | Internist | T-2998 | MS |
Y | 207RH0003X | Hematology & Oncology | 86266 | SC |
N | 207RH0003X | Hematology & Oncology | PENDING | SC |
NPI | 1023499076 |
---|---|
Provider Name | Nikhil Baldev Patel |
First Address | Myrtle Beach, SC 29572-4128 |
Second Address | Conway, SC 29526-8747 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2015 |
Last Update Date | 01/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01353375 | (05) | MS |