Basic Information
Provider Information
NPI: 1467980045
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: HARSH
MiddleName: NARENDRABHAI
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 19305
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282199305
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 315 MEDICAL PARK DR
Address2: STE 202
City: CONCORD
State: NC
PostalCode: 280251902
CountryCode: US
TelephoneNumber: 7044031911
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/26/2017
LastUpdateDate: 10/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084V0102X2022-00979NCN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
2084N0400X2022-00979NCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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