Provider Demographics
NPI:1174028286
Name:PATEL, UMANG DHARMENDRAKUMAR (MD)
Entity Type:Individual
Prefix:
First Name:UMANG
Middle Name:DHARMENDRAKUMAR
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 1:424 ASHERS FARM RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-6592
Mailing Address - Country:US
Mailing Address - Phone:443-255-0923
Mailing Address - Fax:
Practice Address - Street 1:125 EXECUTIVE DR STE H
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-4155
Practice Address - Country:US
Practice Address - Phone:434-791-1345
Practice Address - Fax:434-773-6811
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0091160207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program