Provider Demographics
NPI:1740259340
Name:PATEL, ANIL J (MD)
Entity type:Individual
Prefix:
First Name:ANIL
Middle Name:J
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:224D CORNWALL ST NW STE 403
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2704
Mailing Address - Country:US
Mailing Address - Phone:703-737-6010
Mailing Address - Fax:571-291-9786
Practice Address - Street 1:224D CORNWALL ST., NW, SUITE 303
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-2704
Practice Address - Country:US
Practice Address - Phone:703-777-8840
Practice Address - Fax:703-777-0887
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101045895207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1740259340Medicaid
VAE67340Medicare UPIN
110007318Medicare ID - Type Unspecified