Provider Demographics
NPI:1275914194
Name:PATEL, ISHEET (MD)
Entity Type:Individual
Prefix:MR
First Name:ISHEET
Middle Name:
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 1:10535 PARK MEADOWS BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-8401
Mailing Address - Country:US
Mailing Address - Phone:303-406-2751
Mailing Address - Fax:303-406-2665
Practice Address - Street 1:10535 PARK MEADOWS BLVD STE 205
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-8401
Practice Address - Country:US
Practice Address - Phone:303-406-2751
Practice Address - Fax:303-406-2665
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT208039390200000X
CODR.0060384207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program