Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35.121716 | OH |
N | 111NI0900X | Internist | 35.121716 | OH |
Y | 207RI0200X | Infectious Disease | 35.121716 | OH |
NPI | 1053635045 |
---|---|
Provider Name | Shruti Hitendrabhai Patel |
First Address | Dayton, OH 45459-4263 |
Second Address | Dayton, OH 45429-2219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2010 |
Last Update Date | 10/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0088147 | (05) | OH |
H513350 | MEDICARE PTAN (01) | OH |