Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 03024 | KY |
NPI | 1003012428 |
---|---|
Provider Name | Dr. Viral Patel |
First Address | Cincinnati, OH 45263-5283 |
Second Address | Crittenden, KY 41030-8956 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2007 |
Last Update Date | 23/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2769277 | (05) | OH |
7100013990 | (05) | KY |