# PATINA MEDICAL GROUP, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467147710
- **Authorized official:** DR. NEIL PATEL MD (CHIEF HEALTH OFFICER)
- **Authorized official phone:** (855) 478-8208

## Contact information

- **Practice address:** 101 N TRYON ST STE 600, CHARLOTTE, NC 28246-0100
- **Practice address phone:** (855) 478-8208
- **Mailing address:** 150 MONUMENT RD STE 500, BALA CYNWYD, PA 19004-1701
- **Mailing address phone:** (855) 478-8208

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/11/2023
- **Last updated:** 04/11/2023