Healthcare Provider Details
I. General information
NPI: 1053497669
Provider Name (Legal Business Name): SMITA HASMUKH PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/27/2006
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1629 K ST NW STE 300
WASHINGTON DC
20006-1631
US
IV. Provider business mailing address
10701 BARN WOOD LN
POTOMAC MD
20854-1327
US
V. Phone/Fax
- Phone: 202-775-0620
- Fax: 240-366-5170
- Phone: 202-775-0620
- Fax: 202-795-9902
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | MD18435 |
| License Number State | DC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | D39045 |
| License Number State | MD |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | D39045 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: