Provider Demographics
NPI:1841372356
Name:PATEL, PRANAV D (MD)
Entity type:Individual
Prefix:
First Name:PRANAV
Middle Name:D
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:PO BOX 748613
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8613
Mailing Address - Country:US
Mailing Address - Phone:434-295-1000
Mailing Address - Fax:
Practice Address - Street 1:545 SUNSET LN
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3914
Practice Address - Country:US
Practice Address - Phone:540-829-4352
Practice Address - Fax:540-829-4260
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237228207RX0202X, 207RH0003X
NC267682207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101237228OtherVIRGINIA MEDICAL LICENSE
VAFP2550487OtherDEA
MDD76793OtherMARYLAND MEDICAL LICENSE
VAFP2550487OtherDEA
NC2010-01078OtherNORTH CAROLINA MEDICAL LICENSE