Provider Demographics
NPI:1962031609
Name:PATEL, JENNY ANOJ (MD)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:ANOJ
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:WUSM PEDS, 1 CHILDRENS PL, MSC 8208-0016-06
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110
Mailing Address - Country:US
Mailing Address - Phone:314-454-6124
Mailing Address - Fax:844-616-1418
Practice Address - Street 1:WUSM PEDS, 1 CHILDRENS PL, MSC 8208-0016-06
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110
Practice Address - Country:US
Practice Address - Phone:314-454-6124
Practice Address - Fax:844-616-1418
Is Sole Proprietor?:No
Enumeration Date:2020-04-04
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN69650208000000X
MN30784208000000X
MO2023013607208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics