Provider Demographics
NPI:1578859716
Name:PATEL, RAJ VINOD (MD)
Entity type:Individual
Prefix:
First Name:RAJ
Middle Name:VINOD
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 751069
Mailing Address - Street 2:ECU PHYSICIANS
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:628 E 12TH ST
Practice Address - Street 2:VIDANT BEAUFORT HOSPITAL
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3409
Practice Address - Country:US
Practice Address - Phone:252-975-4319
Practice Address - Fax:252-975-4185
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2024-02-27
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Provider Licenses
StateLicense IDTaxonomies
NC2013-00338207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC179U3OtherBCBS NC
NC1578859716Medicaid
NC1578859716Medicaid