Provider Demographics
NPI:1851393961
Name:PATEL, RAMESHBHAI (MD)
Entity Type:Individual
Prefix:
First Name:RAMESHBHAI
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 NEW MOODY LN
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-9122
Mailing Address - Country:US
Mailing Address - Phone:502-222-0028
Mailing Address - Fax:502-222-0029
Practice Address - Street 1:1006 NEW MOODY LN
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-9122
Practice Address - Country:US
Practice Address - Phone:502-222-0028
Practice Address - Fax:502-222-0029
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY41987207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017629280004Medicaid
PA039247Medicare ID - Type Unspecified
PA0017629280004Medicaid