Provider Demographics
NPI:1780671859
Name:PATEL, MINAXI G (MD)
Entity Type:Individual
Prefix:
First Name:MINAXI
Middle Name:G
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 BROOKS LN STE 250
Mailing Address - Street 2:
Mailing Address - City:CLAIRTON
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3750
Mailing Address - Country:US
Mailing Address - Phone:412-405-8475
Mailing Address - Fax:412-278-1399
Practice Address - Street 1:1200 BROOKS LN STE 250
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-3750
Practice Address - Country:US
Practice Address - Phone:412-405-8475
Practice Address - Fax:412-278-1399
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038976-L207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA019154OtherHIGHMARK
PA0014923210008Medicaid
PA019159OtherMEDICARE PTAN
PA181358OtherHIGHMARK
PA181358OtherHIGHMARK