Provider Demographics
NPI:1245428804
Name:HARISH K. PATEL, MD, PC
Entity Type:Organization
Organization Name:HARISH K. PATEL, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARISH
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-856-3178
Mailing Address - Street 1:1704 NORTH RD SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2958
Mailing Address - Country:US
Mailing Address - Phone:330-856-3178
Mailing Address - Fax:330-856-5839
Practice Address - Street 1:1704 NORTH RD SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2958
Practice Address - Country:US
Practice Address - Phone:330-856-3178
Practice Address - Fax:330-856-5839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2620613Medicaid
OHPA4177131Medicare PIN
OH2620613Medicaid