Basic Information
| Provider Information | |||||||||
| NPI: | 1700470242 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | BHUMI | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 WILLARD ST APT 135 | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277013282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9193562704 | ||||||||
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| Practice Location | |||||||||
| Address1: | 40 DUKE MEDICINE CIR # 3093 | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277102102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196841817 | ||||||||
| FaxNumber: | 9196818147 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2021 | ||||||||
| LastUpdateDate: | 05/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 0010-11077 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.