Provider Demographics
NPI:1194134668
Name:PATEL, BHUMIKA P (OD)
Entity type:Individual
Prefix:
First Name:BHUMIKA
Middle Name:P
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1569 HAZEL ST
Mailing Address - Street 2:
Mailing Address - City:TEGA CAY
Mailing Address - State:SC
Mailing Address - Zip Code:29708
Mailing Address - Country:US
Mailing Address - Phone:224-848-9385
Mailing Address - Fax:
Practice Address - Street 1:1268 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2341
Practice Address - Country:US
Practice Address - Phone:803-817-9755
Practice Address - Fax:803-327-9843
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1831152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist