Provider Demographics
NPI:1003807017
Name:PATWA, SNEH L (MD)
Entity Type:Individual
Prefix:DR
First Name:SNEH
Middle Name:L
Last Name:PATWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 FIFTH STREET
Mailing Address - Street 2:BLDG 675, AREA B
Mailing Address - City:WPAFB
Mailing Address - State:OH
Mailing Address - Zip Code:45433-7802
Mailing Address - Country:US
Mailing Address - Phone:937-255-4809
Mailing Address - Fax:937-656-4062
Practice Address - Street 1:2325 FIFTH STREET
Practice Address - Street 2:
Practice Address - City:WPAFB
Practice Address - State:OH
Practice Address - Zip Code:45433-7802
Practice Address - Country:US
Practice Address - Phone:937-904-8385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-7960-P207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine