Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 59487 | OH |
NPI | 1073613626 |
---|---|
Provider Name | Dr. Kishor Patel I |
First Address | Rocky River, OH 44116-9998 |
Second Address | Rocky River, OH 44116-9998 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2006 |
Last Update Date | 31/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E76751 | (02) | OH |