Provider Demographics
NPI:1609850049
Name:PATEL, AMIT B (MD)
Entity Type:Individual
Prefix:
First Name:AMIT
Middle Name:B
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 1:1161 BETHEL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2773
Mailing Address - Country:US
Mailing Address - Phone:614-459-0350
Mailing Address - Fax:614-459-0355
Practice Address - Street 1:1161 BETHEL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2773
Practice Address - Country:US
Practice Address - Phone:614-459-0350
Practice Address - Fax:614-459-0355
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-08-5408207R00000X
OH35.085408208M00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2574192Medicaid
OH2574192Medicaid
OH4160352Medicare PIN