Provider Demographics
NPI:1619074382
Name:PATEL, MIHIR VIKRAM (M D)
Entity Type:Individual
Prefix:MR
First Name:MIHIR
Middle Name:VIKRAM
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 1:4404 BARRANCA LANE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104
Mailing Address - Country:US
Mailing Address - Phone:720-733-5270
Mailing Address - Fax:720-733-5271
Practice Address - Street 1:4404 BARRANCA LANE
Practice Address - Street 2:SUITE 101
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104
Practice Address - Country:US
Practice Address - Phone:720-733-5270
Practice Address - Fax:720-733-5271
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0048639207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO65500059Medicaid
CO65500059Medicaid