Healthcare Provider Details

I. General information

NPI: 1912609280
Provider Name (Legal Business Name): PRIYAL NIMESH PATEL DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 OLD PADONIA RD STE 301
COCKEYSVILLE MD
21030-4948
US

IV. Provider business mailing address

4101 CHARLOTTE AVE STE F185
NASHVILLE TN
37209-4066
US

V. Phone/Fax

Practice location:
  • Phone: 410-628-1066
  • Fax: 410-683-1354
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1830
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1830
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: