Provider Demographics
NPI:1194729715
Name:PATEL, PRANAY R (MD)
Entity type:Individual
Prefix:MR
First Name:PRANAY
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3070 REIDVILLE RD
Mailing Address - Street 2:P O BOX170156
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301
Mailing Address - Country:US
Mailing Address - Phone:864-576-5764
Mailing Address - Fax:864-587-3969
Practice Address - Street 1:3070 REIDVILLE RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301
Practice Address - Country:US
Practice Address - Phone:864-576-5764
Practice Address - Fax:864-587-3969
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC20947207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4622Medicaid
SC209474Medicaid
SC209474Medicaid
SCG15407Medicare UPIN
SCP00147760Medicare PIN
SCG154073365Medicare PIN