Provider Demographics
NPI:1043598063
Name:PATEL, BRIJAL PARTHAVKUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIJAL
Middle Name:PARTHAVKUMAR
Last Name:PATEL
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 1:3701 MACCORKLE AVE SE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1525
Mailing Address - Country:US
Mailing Address - Phone:304-720-2345
Mailing Address - Fax:304-720-2347
Practice Address - Street 1:3701 MACCORKLE AVE SE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1525
Practice Address - Country:US
Practice Address - Phone:304-720-2345
Practice Address - Fax:304-720-2347
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN51674207R00000X
NY275773207R00000X
WV30922207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC037871800Medicaid
WV1043598063Medicaid
TNQ028994Medicaid
SCSC63909167Medicare PIN