Provider Demographics
NPI:1447566351
Name:PATEL, SACHIN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:SACHIN
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-3942
Mailing Address - Country:US
Mailing Address - Phone:304-325-8104
Mailing Address - Fax:304-324-4267
Practice Address - Street 1:1027 FREDERICK ST
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701-3942
Practice Address - Country:US
Practice Address - Phone:304-325-8104
Practice Address - Fax:304-324-4267
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV01485363AM0700X
VA0110003393363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical