Healthcare Provider Details

I. General information

NPI: 1760954069
Provider Name (Legal Business Name): DHRUVI PATEL DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2018
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 BAKER CIR
ADAMSTOWN MD
21710-9653
US

IV. Provider business mailing address

11905 GREY SQUIRREL ST
CLARKSBURG MD
20871-6355
US

V. Phone/Fax

Practice location:
  • Phone: 301-644-1646
  • Fax:
Mailing address:
  • Phone: 901-219-1810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number25351
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: