Healthcare Provider Details

I. General information

NPI: 1710207147
Provider Name (Legal Business Name): AMIT KISHORE PATEL M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2010
Last Update Date: 06/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW DEPARTMENT OF EMERGENCY MEDICINE
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

111 MICHIGAN AVE NW DEPARTMENT OF EMERGENCY MEDICINE
WASHINGTON DC
20010-2916
US

V. Phone/Fax

Practice location:
  • Phone: 602-300-0932
  • Fax: 877-991-5568
Mailing address:
  • Phone: 602-300-0932
  • Fax: 877-991-5568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number271883
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number271883
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberMD043956
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: