Healthcare Provider Details

I. General information

NPI: 1700679628
Provider Name (Legal Business Name): KANU PATEL M.D.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7235 HANOVER PKWY STE B
GREENBELT MD
20770-3601
US

IV. Provider business mailing address

7231 HANOVER PKWY STE B
GREENBELT MD
20770-2027
US

V. Phone/Fax

Practice location:
  • Phone: 301-441-3122
  • Fax: 301-441-3124
Mailing address:
  • Phone: 301-441-3122
  • Fax: 301-441-3124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License Number
License Number State

VIII. Authorized Official

Name: KANAIYALAL PATEL
Title or Position: OWNER
Credential: MD
Phone: 301-441-3122