Provider Demographics
NPI:1043234537
Name:PATEL, BHARAT R (MD)
Entity Type:Individual
Prefix:
First Name:BHARAT
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 13705
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24036-3705
Mailing Address - Country:US
Mailing Address - Phone:540-731-2114
Mailing Address - Fax:540-731-2656
Practice Address - Street 1:2900 LAMB CIR
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-6344
Practice Address - Country:US
Practice Address - Phone:540-731-2114
Practice Address - Fax:540-731-2656
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01010313652085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7217625Medicaid
VA7217625Medicaid