Provider Demographics
NPI:1932386703
Name:PATEL, DHAVAL R
Entity Type:Individual
Prefix:DR
First Name:DHAVAL
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 GALLOWS RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3300
Mailing Address - Country:US
Mailing Address - Phone:703-776-4001
Mailing Address - Fax:703-776-7113
Practice Address - Street 1:11800 SUNRISE VALLEY DR STE 500
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-5303
Practice Address - Country:US
Practice Address - Phone:703-437-5977
Practice Address - Fax:703-478-2475
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251417207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1932386703Medicaid
MD221543800Medicaid
DCP01094927OtherRAILROAD MEDICARE
DC097383400Medicaid
VA1932386703Medicaid
DC097383400Medicaid