Organization
SOUTHERN INTERNAL MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHASHIKANT J PATEL MD (MD)
(910) 426-0091
Entity
Organization
Contact information
Practice address
3514 VILLAGE DR, FAYETTEVILLE, NC 28304-4554
(910) 426-0091
(910) 426-0093
Mailing address
3514 VILLAGE DR, FAYETTEVILLE, NC 28304-4554
(910) 426-0091
(910) 426-0093
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
130620
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891208P
—
NC
Enumeration date
11/20/2006
Last updated
10/17/2008
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