Provider Demographics
NPI:1902646524
Name:PATEL, RADHA (PA-C)
Entity type:Individual
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First Name:RADHA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:3 RICHLAND MEDICAL PARK DR STE 120
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6850
Practice Address - Country:US
Practice Address - Phone:803-434-8866
Practice Address - Fax:803-933-3049
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-09-26
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Provider Licenses
StateLicense IDTaxonomies
363A00000X
SC5404363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant