1164413159 NPI number — DR. PIYUSH D PATEL M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164413159 NPI number — DR. PIYUSH D PATEL M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

PATEL

Provider First Name:

PIYUSH

Provider Middle Name:

D

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1164413159

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

04/19/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

6218 MONTROSE RD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

ROCKVILLE

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

20852-4119

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

703-841-1290

Provider Business Mailing Address Fax Number:

301-255-0110

Provider First Line Business Practice Location Address:

6218 MONTROSE RD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

ROCKVILLE

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

20852-4119

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

703-841-1290

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

10/31/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2084N0400X , with the licence number:  KY20046 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2084P0800X , with the licence number: KY20046 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2084P0800X , with the licence number: D0088750 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 18S132 . This is a "GERI-PSY PROVIDER #-HOSPI" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 260004117 . This is a "MC RAILROAD" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 64200462 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
• Identifier: 1161185 . This is a "CHA PROVIDER #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 18T132 . This is a "REHAB PROVIDER #-HOSPITAL" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 000000110878 . This is a "BCBS PROVIDER#" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 180132 . This is a "ACUTE PROVIDER # HOSPITAL" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 185407 . This is a "SNF PROVIDER # HOSPITAL" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 611117863 . This is a "TAX ID USED TO BILL INS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".