Healthcare Provider Details

I. General information

NPI: 1245495845
Provider Name (Legal Business Name): MALAYKUMAR MANILAL PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SE HOSPITAL AVE # 2346
STUART FL
34994-2346
US

IV. Provider business mailing address

2600 6TH ST SW
CANTON OH
44710-1702
US

V. Phone/Fax

Practice location:
  • Phone: 772-287-5200
  • Fax:
Mailing address:
  • Phone: 330-363-2922
  • Fax: 330-363-6008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number35.096838
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35.096838
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: