Individual
SUPEN R PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 E PALMETTO ST, FLORENCE, SC 29506
(843) 667-9414
(843) 667-1362
Mailing address
360 N IRBY ST, FLORENCE, SC 29501-2808
(843) 667-9414
(843) 667-1362
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
19744
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
660002624
RAILROAD MEDICARE
SC
05
—
89063RJ
—
NC
05
—
T37467
—
SC
Enumeration date
06/12/2006
Last updated
01/02/2019
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