Provider Demographics
NPI:1972529873
Name:PATEL, PIYUSH VINAYKUMAR (MD)
Entity Type:Individual
Prefix:
First Name:PIYUSH
Middle Name:VINAYKUMAR
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 1:3170 KETTERING BLVD BLDG B3
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1924
Mailing Address - Country:US
Mailing Address - Phone:937-991-3100
Mailing Address - Fax:937-223-9811
Practice Address - Street 1:400 SUGAR CAMP CIR STE 200
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:OH
Practice Address - Zip Code:45409-1981
Practice Address - Country:US
Practice Address - Phone:937-276-8320
Practice Address - Fax:937-276-8325
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 . 090596208M00000X
OH35.090596207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2793277Medicaid
OH2793277Medicaid