Individual
CHARLOTTE MEDLOCK PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1690 SKYLYN DR STE 210, SPARTANBURG, SC 29307-1075
(864) 253-8170
(864) 585-7787
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
83760
SC
207Q00000X
Family Medicine Physician
OT018844
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
837607
—
SC
01
—
SCL5216084
MEDICARE PIN
SC
Enumeration date
06/27/2018
Last updated
12/03/2021
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