Provider Demographics
NPI:1376862144
Name:PATEL, RUPAL K (MD)
Entity Type:Individual
Prefix:
First Name:RUPAL
Middle Name:K
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 5TH ST SE
Mailing Address - Street 2:SUITE T
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-4260
Mailing Address - Country:US
Mailing Address - Phone:330-697-7313
Mailing Address - Fax:
Practice Address - Street 1:103 5TH ST SE
Practice Address - Street 2:SUITE T
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-4260
Practice Address - Country:US
Practice Address - Phone:330-697-7313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-122793207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine