Provider Demographics
NPI:1124224936
Name:PATEL, CHIRAG C (MD)
Entity Type:Individual
Prefix:
First Name:CHIRAG
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 NEIL AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-7310
Mailing Address - Country:US
Mailing Address - Phone:614-464-3937
Mailing Address - Fax:
Practice Address - Street 1:262 NEIL AVE
Practice Address - Street 2:STE 220
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-7310
Practice Address - Country:US
Practice Address - Phone:614-464-3937
Practice Address - Fax:614-464-0088
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35122157207W00000X
IN01069289207W00000X
CO47547207W00000X
OH35.122157207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201035690Medicaid
CO68673078Medicaid
CO68673078Medicaid
OHH196530Medicare PIN
COCO305110Medicare PIN