Provider Demographics
NPI:1821474289
Name:PATEL, RAVI JAGDISH (DO)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:JAGDISH
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 1:6380 HOMEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-8308
Mailing Address - Country:US
Mailing Address - Phone:540-314-0229
Mailing Address - Fax:
Practice Address - Street 1:6380 HOMEWOOD CIR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-8308
Practice Address - Country:US
Practice Address - Phone:540-314-0229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102206209207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine