Healthcare Provider Details

I. General information

NPI: 1457268039
Provider Name (Legal Business Name): VIVEKBHAI DINESHBHAI PATEL MPT, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 JERMOR LN
WESTMINSTER MD
21157-6126
US

IV. Provider business mailing address

347 CHERRYSTONE CT
REISTERSTOWN MD
21136-6211
US

V. Phone/Fax

Practice location:
  • Phone: 443-381-2896
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number31040
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: