Provider Demographics
NPI:1942592258
Name:PATEL, SACHIN VIJAY (MD)
Entity Type:Individual
Prefix:DR
First Name:SACHIN
Middle Name:VIJAY
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 1:3609 PARK EAST DR STE 207
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4309
Mailing Address - Country:US
Mailing Address - Phone:216-360-0456
Mailing Address - Fax:216-360-9449
Practice Address - Street 1:3609 PARK EAST DR STE 207
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4309
Practice Address - Country:US
Practice Address - Phone:216-360-0456
Practice Address - Fax:216-360-9449
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPATE4393848207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPATE4393848OtherOHIO MEDICAL LICENSE NUMBER