Provider Demographics
NPI:1811915598
Name:PATEL, ASHISH MADHOOP (MD)
Entity type:Individual
Prefix:
First Name:ASHISH
Middle Name:MADHOOP
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5200 COMMERCE CROSSINGS DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-2182
Mailing Address - Country:US
Mailing Address - Phone:502-253-4924
Mailing Address - Fax:502-489-4750
Practice Address - Street 1:107 MERIDIAN WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2878
Practice Address - Country:US
Practice Address - Phone:859-624-6366
Practice Address - Fax:859-624-6367
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2020-12-07
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Provider Licenses
StateLicense IDTaxonomies
KY31014207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64310147Medicaid
KY64310147Medicaid
KYK059340Medicare PIN