Healthcare Provider Details

I. General information

NPI: 1881366359
Provider Name (Legal Business Name): PAYAL ATUL PATEL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 G ST NW STE 200E
WASHINGTON DC
20001-4546
US

IV. Provider business mailing address

1001 G ST NW STE 200E
WASHINGTON DC
20001-4546
US

V. Phone/Fax

Practice location:
  • Phone: 888-663-6331
  • Fax: 415-252-7176
Mailing address:
  • Phone: 888-663-6331
  • Fax: 415-252-7176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA200001300
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085008483
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: