Provider Demographics
NPI:1003012428
Name:PATEL, VIRAL (DO)
Entity Type:Individual
Prefix:DR
First Name:VIRAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-428-1610
Mailing Address - Fax:859-428-3923
Practice Address - Street 1:405 VIOLET RD
Practice Address - Street 2:
Practice Address - City:CRITTENDEN
Practice Address - State:KY
Practice Address - Zip Code:41030-8956
Practice Address - Country:US
Practice Address - Phone:859-428-1610
Practice Address - Fax:859-428-3923
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03024207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2769277Medicaid
KY7100013990Medicaid
OH2769277Medicaid
KY7100013990Medicaid