Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 83157 | SC |
NPI | 1215355797 |
---|---|
Provider Name | Shiven S Patel |
First Address | Greenville, SC 29601-2842 |
Second Address | Easley, SC 29640-1406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 20/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
831577 | (05) | SC |