Provider Demographics
NPI:1013597863
Name:PATEL, DEVEN BIPIN (DPM)
Entity type:Individual
Prefix:
First Name:DEVEN
Middle Name:BIPIN
Last Name:PATEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4357 FERGUSON DR STE 150
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1760
Mailing Address - Country:US
Mailing Address - Phone:513-474-4450
Mailing Address - Fax:513-474-6387
Practice Address - Street 1:4357 FERGUSON DR STE 150
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1760
Practice Address - Country:US
Practice Address - Phone:513-474-4450
Practice Address - Fax:513-474-6387
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.004137213E00000X
OH59.000890213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty