Provider Demographics
NPI:1881896777
Name:PATEL, KETAN B (MD)
Entity type:Individual
Prefix:DR
First Name:KETAN
Middle Name:B
Last Name:PATEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:11350 MCCORMICK ROAD
Mailing Address - Street 2:EXECUTIVE PLAZA 1, SUITE 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031
Mailing Address - Country:US
Mailing Address - Phone:410-329-1071
Mailing Address - Fax:410-329-1054
Practice Address - Street 1:15195 HEATHCOAT BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169
Practice Address - Country:US
Practice Address - Phone:703-914-8000
Practice Address - Fax:703-642-1876
Is Sole Proprietor?:No
Enumeration Date:2007-06-03
Last Update Date:2021-07-26
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Provider Licenses
StateLicense IDTaxonomies
VA0101251492208VP0014X
CAA115700207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine