Individual
MANISH GOVIND PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
128 MEDICAL PARK RD, SUITE 101, MOORESVILLE, NC 28117-8578
(704) 658-1001
(704) 658-1002
Mailing address
650 SIGNAL HILL DRIVE EXT, PO BOX 1845, STATESVILLE, NC 28625-4353
(704) 873-4277
(704) 873-4511
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200001518
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8912991
—
NC
Enumeration date
11/07/2005
Last updated
08/15/2023
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