Provider Demographics
NPI:1649383712
Name:PATEL, YATIN J (MD)
Entity type:Individual
Prefix:
First Name:YATIN
Middle Name:J
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:PO BOX 6083
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-0083
Mailing Address - Country:US
Mailing Address - Phone:410-465-8503
Mailing Address - Fax:410-465-8570
Practice Address - Street 1:10290 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-3670
Practice Address - Country:US
Practice Address - Phone:410-465-8503
Practice Address - Fax:410-465-8570
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0097789207RP1001X
IN01042551207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100386250AMedicaid
228920Medicare ID - Type Unspecified
F47270Medicare UPIN