Individual
KAMLESH PANUBHAI PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 MEDICAL DR, SUITE B, FAYETTEVILLE, NC 28304-4425
(910) 486-8080
(910) 486-8090
Mailing address
PO BOX 87511, FAYETTEVILLE, NC 28304-7511
(910) 486-8080
(910) 486-8090
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
96-01029
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2230883C
MEDICARE INDIVIDUAL NUMBE
NC
01
—
2335759
MEDICARE GROUP NUMBER
NC
01
—
5892258
AETNA
—
01
—
65846
BCBS NC
—
05
—
8965846
—
NC
Enumeration date
07/28/2005
Last updated
05/30/2012
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