Individual
PRAVINKUMAR KANTILAL PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4140 FERNCREEK DR STE 501, FERNCREEK PRIMARY CARE, PC, FAYETTEVILLE, NC 28314-2568
(910) 491-3922
(910) 491-5350
Mailing address
4140 FERNCREEK DR, FERNCREEK PRIMARY CARE, PC, FAYETTEVILLE, NC 28314-2563
(910) 491-3922
(910) 491-5350
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9501632
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11199
BCBS
—
05
—
1669449179
—
NC
Enumeration date
03/02/2006
Last updated
06/15/2016
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