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Individual

DR. JAY KRISHNAVADAN PATEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MB.CHB

Contact information

Practice address
309 NEW ST, CAROLINA KIDNEY ASSOCIATES, GREENSBORO, NC 27405-3654
(336) 379-9708
(336) 553-2085
Mailing address
309 NEW ST, CAROLINA KIDNEY ASSOCIATES, GREENSBORO, NC 27405-3654
(336) 379-9708
(336) 553-2085

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
121946
NC
207RN0300X
Nephrology Physician
Primary
278088
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
56-1274347
CAROLINA KIDNEY'S TAX ID
NC
05
5908623
NC
01
P00905301
RAILROAD MEDICARE
NC
Enumeration date
03/26/2007
Last updated
07/09/2021
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