Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 34.011842 | OH |
NPI | 1306187455 |
---|---|
Provider Name | Vikas D Patel |
First Address | Lorain, OH 44053 |
Second Address | Lorain, OH 44053-4131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2013 |
Last Update Date | 17/03/2018 |