Provider Demographics
NPI:1679637946
Name:PATEL, NILESH SHANTILAL (MD)
Entity Type:Individual
Prefix:MR
First Name:NILESH
Middle Name:SHANTILAL
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:25 CROSSROADS DR
Mailing Address - Street 2:STE 306
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5437
Mailing Address - Country:US
Mailing Address - Phone:443-738-2889
Mailing Address - Fax:443-471-8540
Practice Address - Street 1:900 E OAK HILL AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-4505
Practice Address - Country:US
Practice Address - Phone:865-859-7020
Practice Address - Fax:865-859-3706
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2020-11-10
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Provider Licenses
StateLicense IDTaxonomies
GA0548502085R0001X
TN420032085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RII56773Medicare UPIN