Basic Information
| Provider Information | |||||||||
| NPI: | 1467614792 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | RAKESH | ||||||||
| MiddleName: | MANEKLAL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 E MCBEE AVE FL 4 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296012842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645228603 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 100 PALMETTO HEALTH PKWY STE 350 | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292121756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8039072020 | ||||||||
| FaxNumber: | 8039077720 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2008 | ||||||||
| LastUpdateDate: | 08/11/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | FP3133600 | IL | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 37450 | SC | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207WX0200X | 37450 | SC | Y |
ID Information
| ID | Type | State | Issuer | Description | 374507 | 05 | SC | MEDICAID |