Provider Demographics
NPI:1164413159
Name:PATEL, PIYUSH D (MD)
Entity Type:Individual
Prefix:DR
First Name:PIYUSH
Middle Name:D
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 1:6218 MONTROSE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4119
Mailing Address - Country:US
Mailing Address - Phone:703-841-1290
Mailing Address - Fax:301-255-0110
Practice Address - Street 1:6218 MONTROSE RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4119
Practice Address - Country:US
Practice Address - Phone:703-841-1290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY200462084N0400X, 2084P0800X
MDD00887502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY18S132OtherGERI-PSY PROVIDER #-HOSPI
KY260004117OtherMC RAILROAD
KY64200462Medicaid
KY1161185OtherCHA PROVIDER #
KY18T132OtherREHAB PROVIDER #-HOSPITAL
KY000000110878OtherBCBS PROVIDER#
KY180132OtherACUTE PROVIDER # HOSPITAL
KY185407OtherSNF PROVIDER # HOSPITAL
KY611117863OtherTAX ID USED TO BILL INS
KY180132OtherACUTE PROVIDER # HOSPITAL
KY0622001Medicare ID - Type UnspecifiedMEDICARE PROVIDER #