Provider Demographics
NPI:1659653863
Name:PATEL, SANDIPKUMAR A (RPH)
Entity Type:Individual
Prefix:MR
First Name:SANDIPKUMAR
Middle Name:A
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ELIZABETH PL STE 1015
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-3475
Mailing Address - Country:US
Mailing Address - Phone:937-424-4599
Mailing Address - Fax:937-424-5944
Practice Address - Street 1:1 ELIZABETH PL # 1015
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3445
Practice Address - Country:US
Practice Address - Phone:937-424-4599
Practice Address - Fax:937-424-5944
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035266183500000X
VA0202207286183500000X
OH03338020183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist