Provider Demographics
NPI:1407172877
Name:PATEL, DHRUTI MUKUND (MD)
Entity Type:Individual
Prefix:
First Name:DHRUTI
Middle Name:MUKUND
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 1:8539 RUPP FARM DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-4526
Mailing Address - Country:US
Mailing Address - Phone:513-623-9298
Mailing Address - Fax:
Practice Address - Street 1:1090 AMSTERDAM AVE STE 7G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1737
Practice Address - Country:US
Practice Address - Phone:212-523-3340
Practice Address - Fax:212-523-2922
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-10
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 129639208800000X
GA83049208800000X
390200000X
NY311067208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program