Provider Demographics
NPI:1780722397
Name:PATEL, JAYKUMAR H (DO)
Entity type:Individual
Prefix:DR
First Name:JAYKUMAR
Middle Name:H
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:JAY
Other - Middle Name:H
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:37 E FORT AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-4538
Mailing Address - Country:US
Mailing Address - Phone:516-695-6510
Mailing Address - Fax:
Practice Address - Street 1:201 E UNIVERSITY PKWY
Practice Address - Street 2:33RD STREET PROFESSIONAL BUILDING SUITE 226
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2829
Practice Address - Country:US
Practice Address - Phone:410-955-4552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0069217207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology