Individual
NISHITH G PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2626 BRANDERMILL BLVD, GAMBRILLS, MD 21054-1651
(410) 451-9499
Mailing address
2626 BRANDERMILL BLVD, GAMBRILLS, MD 21054-1651
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA2261
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TA2261
MD BOARD OF OPTOMETRY
MD
Enumeration date
08/08/2011
Last updated
08/08/2011
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