Provider Demographics
NPI:1801857743
Name:PATEL, JASHBHAI N (MD)
Entity Type:Individual
Prefix:DR
First Name:JASHBHAI
Middle Name:N
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:111 PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-2790
Mailing Address - Country:US
Mailing Address - Phone:276-935-6476
Mailing Address - Fax:276-935-7270
Practice Address - Street 1:1520 SLATE CREEK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:GRUNDY
Practice Address - State:VA
Practice Address - Zip Code:24614-6975
Practice Address - Country:US
Practice Address - Phone:276-935-6476
Practice Address - Fax:276-395-4430
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101033235208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007374551Medicaid
1308637OtherFUNDS
WV0128711000Medicaid
017128500OtherBLACK LUNG
VAP 00295752OtherMEDICARE RAILROAD
VA001876OtherANTHEM
KY64663222Medicaid
1308637OtherFUNDS
020000092Medicare ID - Type Unspecified