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NPI Code Detail

MEDICARE: ANKUR RAJENDRA PATEL O.D.

MEDICARE: ANKUR RAJENDRA PATEL O.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
1152W00000XOptometrist4901005446MI
2152W00000XOptometrist0620000075VA
3152W00000XOptometrist06180036063VA

General Provider Information

NPI Number : 1801412341
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANKUR RAJENDRA PATEL O.D.
Provider Business Mailing Address
First Line : PO BOX 45923
Second Line :
City : BALTIMORE
State : MD
Zip : 21297-5923
Country : US
Telephone Number : 877-969-0392
Fax Number :
Provider Business Practice Location Address
First Line : 4244 VIRGINIA AVE
Second Line :
City : COLLINSVILLE
State : VA
Zip : 24078-1935
Country : US
Telephone Number : 276-647-3766
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2020
Last Update Date : 09/19/2025

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