Provider Demographics
NPI:1639327018
Name:PATEL, AMEE MAYUR (DO)
Entity Type:Individual
Prefix:
First Name:AMEE
Middle Name:MAYUR
Last Name:PATEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 E LIBERTY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1428
Mailing Address - Country:US
Mailing Address - Phone:502-210-4430
Mailing Address - Fax:502-210-4345
Practice Address - Street 1:2401 TERRA CROSSING BLVD STE 405
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-5371
Practice Address - Country:US
Practice Address - Phone:502-210-4430
Practice Address - Fax:502-210-4345
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY03394207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100184730Medicaid
KYP01040891Medicare PIN
KY7100184730Medicaid