Provider Demographics
NPI:1053497669
Name:PATEL, SMITA HASMUKH (MD)
Entity Type:Individual
Prefix:DR
First Name:SMITA
Middle Name:HASMUKH
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 1:10701 BARN WOOD LN
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1327
Mailing Address - Country:US
Mailing Address - Phone:202-775-0620
Mailing Address - Fax:202-795-9902
Practice Address - Street 1:1629 K ST NW STE 300
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1631
Practice Address - Country:US
Practice Address - Phone:202-775-0620
Practice Address - Fax:240-366-5170
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD184352084P0800X
MDD390452084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD077851600Medicaid
MD077851600Medicaid
MDE69949Medicare UPIN