Provider Demographics
NPI:1881684124
Name:PATEL, SAUMIL VINUBHAI (MD)
Entity type:Individual
Prefix:
First Name:SAUMIL
Middle Name:VINUBHAI
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 1:160 KINGSLEY LN
Mailing Address - Street 2:SUITE 100 A
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-4600
Mailing Address - Country:US
Mailing Address - Phone:757-889-5335
Mailing Address - Fax:
Practice Address - Street 1:160 KINGSLEY LN
Practice Address - Street 2:SUITE 100 A
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-4600
Practice Address - Country:US
Practice Address - Phone:757-889-5335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101248010207RC0000X
KY40262207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVAA102518Medicare PIN
VAVAA102516Medicare PIN
VAVAA102519Medicare PIN