Provider Demographics
NPI:1598722092
Name:PATEL, ASHOK RAVJIBHAI (M D)
Entity Type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:RAVJIBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 MONUMENT AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-2718
Mailing Address - Country:US
Mailing Address - Phone:804-353-4703
Mailing Address - Fax:
Practice Address - Street 1:2015 MONUMENT AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-2718
Practice Address - Country:US
Practice Address - Phone:804-353-4703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038672207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6055133Medicaid
110002008Medicare ID - Type Unspecified
VA6055133Medicaid