Provider Demographics
NPI:1003100405
Name:PATEL, DIXABEN RAHUL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DIXABEN
Middle Name:RAHUL
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DIXA
Other - Middle Name:RAHUL
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:10 CROOKED RUN PLZ
Mailing Address - Street 2:T-2297
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-7004
Mailing Address - Country:US
Mailing Address - Phone:540-631-3291
Mailing Address - Fax:540-631-3400
Practice Address - Street 1:10 CROOKED RUN PLZ
Practice Address - Street 2:T-2297
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-7004
Practice Address - Country:US
Practice Address - Phone:540-631-3291
Practice Address - Fax:540-631-3400
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202209021183500000X
CTPCT.0011197183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist