Healthcare Provider Details

I. General information

NPI: 1851393961
Provider Name (Legal Business Name): RAMESHBHAI PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 09/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 NEW MOODY LN
LA GRANGE KY
40031-9122
US

IV. Provider business mailing address

1006 NEW MOODY LN
LA GRANGE KY
40031-9122
US

V. Phone/Fax

Practice location:
  • Phone: 502-222-0028
  • Fax: 502-222-0029
Mailing address:
  • Phone: 502-222-0028
  • Fax: 502-222-0029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number41987
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number41987
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: