Provider Demographics
NPI:1770863490
Name:PATANKAR, NIKHIL S (MD)
Entity type:Individual
Prefix:DR
First Name:NIKHIL
Middle Name:S
Last Name:PATANKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6836 PIERSHILL LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-1566
Mailing Address - Country:US
Mailing Address - Phone:716-464-8367
Mailing Address - Fax:
Practice Address - Street 1:1600 WALLACE BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1799
Practice Address - Country:US
Practice Address - Phone:806-212-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01078004A208000000X, 2080P0203X
MDD00957202080P0203X
NC2023-000562080P0203X
MI43015069292080P0203X
VA01012752692080P0203X
WV332162080P0203X
GA959552080P0203X
TXT66672080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYLXK 881219701OtherBLUECROSS BLUESHIELD