Individual
VINAY JAY PATIDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
905 VERDAE BLVD STE 101, GREENVILLE, SC 29607-4029
(864) 522-1050
Mailing address
905 VERDAE BLVD STE 101, GREENVILLE, SC 29607-4029
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2018-02335
NC
207Q00000X
Family Medicine Physician
Primary
40062
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400622
—
SC
Enumeration date
04/09/2013
Last updated
07/09/2021
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