Provider Demographics
NPI:1003254202
Name:PATEL, PRACHI TONI (DO)
Entity Type:Individual
Prefix:MS
First Name:PRACHI
Middle Name:TONI
Last Name:PATEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:5450 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2709
Mailing Address - Country:US
Mailing Address - Phone:303-415-4157
Mailing Address - Fax:303-776-3109
Practice Address - Street 1:2101 KEN PRATT BLVD STE 104
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6568
Practice Address - Country:US
Practice Address - Phone:303-415-4157
Practice Address - Fax:303-776-3109
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0057563207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine