Provider Demographics
NPI:1295820827
Name:PATEL, KINJAL RAMESH (MD)
Entity Type:Individual
Prefix:DR
First Name:KINJAL
Middle Name:RAMESH
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3930 WALNUT STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4738
Mailing Address - Country:US
Mailing Address - Phone:703-246-9246
Mailing Address - Fax:703-246-9257
Practice Address - Street 1:3930 WALNUT STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4738
Practice Address - Country:US
Practice Address - Phone:703-246-9246
Practice Address - Fax:703-246-9257
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101230883207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010084555Medicaid
VA010084636Medicaid
47430008OtherCAREFIRST
VA010084652Medicaid
VA010084687Medicaid
VA010084032Medicaid
VA010084784Medicaid
VA010083800Medicaid
VA010083834Medicaid
VA010084822Medicaid
5366290OtherCIGNA
2129869OtherMAMSI
VA010083958Medicaid
VA010084008Medicaid
VA010084687Medicaid
VA010084784Medicaid