Healthcare Provider Details

I. General information

NPI: 1568143238
Provider Name (Legal Business Name): SARAL JAYANTILAL PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 07/26/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

717 MARTIN LUTHER KING DR W APT C210
CINCINNATI OH
45220-2531
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4454
  • Fax:
Mailing address:
  • Phone: 929-585-9907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number57.254040
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: