Individual
SUDHIRKUMAR VINODCHANDRA PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 BROOKSIDE DR, 3RD FLOOR, KINGSPORT, TN 37660-4627
(423) 857-5905
(423) 857-5904
Mailing address
2000 BROOKSIDE DR, 3RD FLOOR, KINGSPORT, TN 37660-4627
(423) 857-5905
(423) 857-5904
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
42674
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1506080
—
TN
05
—
1515079
—
TN
05
—
1515080
—
TN
05
—
1912192576
—
NC
05
—
1912192576
—
VA
05
—
3000972
—
TN
01
—
4188131
BC/BS
TN
05
—
5913115
—
NC
05
—
7100036600
—
KY
05
—
Q002698
—
TN
Enumeration date
09/07/2007
Last updated
02/21/2017
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