Provider Demographics
NPI:1639707359
Name:PATEL, NOLAN PARESH (DO)
Entity Type:Individual
Prefix:
First Name:NOLAN
Middle Name:PARESH
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4151 BLADENSBURG RD
Mailing Address - Street 2:
Mailing Address - City:COLMAR MANOR
Mailing Address - State:MD
Mailing Address - Zip Code:20722-1928
Mailing Address - Country:US
Mailing Address - Phone:301-699-7700
Mailing Address - Fax:
Practice Address - Street 1:9500 RICHMOND HWY
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-2124
Practice Address - Country:US
Practice Address - Phone:571-800-8915
Practice Address - Fax:833-954-5512
Is Sole Proprietor?:No
Enumeration Date:2020-03-29
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0102208069207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program