Provider Demographics
NPI:1376744672
Name:PATIL, NEIL A (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:A
Last Name:PATIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:10401 SPOTSYLVANIA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-8606
Mailing Address - Country:US
Mailing Address - Phone:540-361-1000
Mailing Address - Fax:540-361-7010
Practice Address - Street 1:1001 SAM PERRY BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4453
Practice Address - Country:US
Practice Address - Phone:540-361-1000
Practice Address - Fax:540-361-7010
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2007-007182085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1376744672Medicaid
VAMC10182Medicare PIN
VAP00621617Medicare PIN
VAP00665009Medicare PIN
VAMC10317Medicare PIN
VAP00665009Medicare PIN