Provider Demographics
NPI:1518974799
Name:PATEL, BABITA B
Entity Type:Individual
Prefix:
First Name:BABITA
Middle Name:B
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 N MAIN ST STE H
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592-2547
Mailing Address - Country:US
Mailing Address - Phone:434-517-6180
Mailing Address - Fax:434-517-6179
Practice Address - Street 1:1129 N MAIN ST STE H
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592-2547
Practice Address - Country:US
Practice Address - Phone:434-517-6180
Practice Address - Fax:434-517-6179
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101234845207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010014875Medicaid
VA266857OtherANTHEM
VAP00064711OtherRRMI CARE
VA010014875Medicaid
VA00V533586Medicare ID - Type Unspecified