Individual
BHADRIK I PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1120 SPARKLEBERRY LANE EXT STE A&B, COLUMBIA, SC 29223-7078
(803) 851-0605
(803) 769-7886
Mailing address
1120 SPARKLEBERRY LANE EXT STE A&B, COLUMBIA, SC 29223-7078
(803) 851-0605
(803) 769-7886
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1501
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N110
MEDICARE
SC
01
—
PA1501
MEDICAL LICENSE
SC
05
—
PG1133
—
SC
Enumeration date
06/24/2009
Last updated
02/01/2024
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