Provider Demographics
NPI:1841273059
Name:PATEL, DINESCHANDRA G (MD)
Entity type:Individual
Prefix:
First Name:DINESCHANDRA
Middle Name:G
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 1:860 E BROAD ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-6542
Mailing Address - Country:US
Mailing Address - Phone:440-323-8458
Mailing Address - Fax:440-323-7900
Practice Address - Street 1:630 E RIVER ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-9915
Practice Address - Country:US
Practice Address - Phone:440-323-8458
Practice Address - Fax:440-323-7900
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35042973207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0428002Medicare ID - Type Unspecified