Healthcare Provider Details

I. General information

NPI: 1558006189
Provider Name (Legal Business Name): MRUNAL MAHESHBHAI PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2022
Last Update Date: 07/30/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BARNES JEWISH HOSPITAL PLZ
SAINT LOUIS MO
63110-1003
US

IV. Provider business mailing address

1350 EAST MARKET STREET WESTERN RESERVE HEALTH EDUCATIO TRUMBULL REGIONAL MEDICAL CENTER
WARREN OH
44483
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-1700
  • Fax:
Mailing address:
  • Phone: 330-841-9647
  • Fax: 330-841-9645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2025026540
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: