Provider Demographics
NPI:1699329342
Name:PATEL, EKTA
Entity type:Individual
Prefix:
First Name:EKTA
Middle Name:
Last Name:PATEL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6217 OLD KEENE MILL CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-2324
Mailing Address - Country:US
Mailing Address - Phone:703-451-0232
Mailing Address - Fax:
Practice Address - Street 1:611 S CARLIN SPRINGS RD STE 508
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1088
Practice Address - Country:US
Practice Address - Phone:703-566-0803
Practice Address - Fax:571-867-9905
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301403213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery