Provider Demographics
NPI:1164480794
Name:PATEL, TUSHAR RAMESCHANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:TUSHAR
Middle Name:RAMESCHANDRA
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 1:780 LYNNHAVEN PKWY
Mailing Address - Street 2:STE 400
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7332
Mailing Address - Country:US
Mailing Address - Phone:757-468-0550
Mailing Address - Fax:757-468-9992
Practice Address - Street 1:780 LYNNHAVEN PKWY
Practice Address - Street 2:STE 400
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7332
Practice Address - Country:US
Practice Address - Phone:757-468-0550
Practice Address - Fax:757-468-9992
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012391812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
192145OtherANTHEM PPO BCBS
268181OtherCOMPSYCH
192145OtherANTHEM BCBS
192145OtherANTHEM HEALTH KEEPERS
192145OtherANTHEM HEALTH KEEPERS
192145OtherANTHEM PPO BCBS