Provider Demographics
NPI:1528226016
Name:PATEL, MIHIR (MD)
Entity Type:Individual
Prefix:DR
First Name:MIHIR
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 N STATE OF FRANKLIN RD STE 24
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-6048
Mailing Address - Country:US
Mailing Address - Phone:423-431-1810
Mailing Address - Fax:423-431-1811
Practice Address - Street 1:408 N STATE OF FRANKLIN RD STE 24
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6048
Practice Address - Country:US
Practice Address - Phone:423-431-1810
Practice Address - Fax:423-431-1811
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47533207R00000X, 208M00000X
VA0101249954207R00000X, 208M00000X
WAMD60848980207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1525416Medicaid
VA1528226016Medicaid
TN103I112595Medicare PIN
VAV V3541BMedicare PIN
VA1528226016Medicaid
TN1525416Medicaid
TN10311I3992Medicare PIN