Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MT189897 | PA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 35.097039 | OH |
NPI | 1366619280 |
---|---|
Provider Name | Jignesh Patel |
First Address | Dayton, OH 45409-2939 |
Second Address | Dayton, OH 45409-2939 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2008 |
Last Update Date | 08/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0052200 | (05) | OH |
H026877 | (02) | OH |