Provider Demographics
NPI:1396953469
Name:PATEL, MANOJKUMAR D (MD)
Entity type:Individual
Prefix:
First Name:MANOJKUMAR
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-686-3508
Mailing Address - Fax:757-686-0541
Practice Address - Street 1:725 VOLVO PKWY
Practice Address - Street 2:STE 102
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1621
Practice Address - Country:US
Practice Address - Phone:757-609-3380
Practice Address - Fax:757-609-3384
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2017-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101242058207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVE614CMedicare PIN
VAVVE614AMedicare PIN
VAVVE614BMedicare PIN