Provider Demographics
NPI:1568458362
Name:PATEL, MEENAKSHI C (MD)
Entity Type:Individual
Prefix:
First Name:MEENAKSHI
Middle Name:C
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 1:6611 CLYO RD
Mailing Address - Street 2:SUTIE E
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-2786
Mailing Address - Country:US
Mailing Address - Phone:937-208-8283
Mailing Address - Fax:937-208-8293
Practice Address - Street 1:6611 CLYO RD
Practice Address - Street 2:SUTIE E
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-2786
Practice Address - Country:US
Practice Address - Phone:937-208-8283
Practice Address - Fax:937-208-8293
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35053688P207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0693807Medicaid
OHPA0607664Medicare ID - Type Unspecified
OH0693807Medicaid