Provider Demographics
NPI:1477843969
Name:PATEL, KAVITA DALI (MD)
Entity Type:Individual
Prefix:
First Name:KAVITA
Middle Name:DALI
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 1:8908 RIGGS RD
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1632
Mailing Address - Country:US
Mailing Address - Phone:301-422-5900
Mailing Address - Fax:301-000-0000
Practice Address - Street 1:8908 RIGGS RD
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-1632
Practice Address - Country:US
Practice Address - Phone:301-422-5900
Practice Address - Fax:301-000-0000
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2021-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-00485207Q00000X
MDD0091230207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine