MEDICARE: DR. CHANDRAVADAN P. PATEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	35051607	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598883068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHANDRAVADAN P. PATEL M.D.

Provider Business Mailing Address
First Line	:	809 COSHOCTON AVE
Second Line	:	SUITE C
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-1900
Country	:	US
Telephone Number	:	740-397-1900
Fax Number	:	740-397-1900

Provider Business Practice Location Address
First Line	:	809 COSHOCTON AVE
Second Line	:	SUITE C
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-1900
Country	:	US
Telephone Number	:	740-397-1900
Fax Number	:	740-397-1900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	11/02/2012

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