Healthcare Provider Details
I. General information
NPI: 1194385351
Provider Name (Legal Business Name): DIXITA M. PATEL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/19/2019
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
460 W 10TH AVE
COLUMBUS OH
43210-1240
US
IV. Provider business mailing address
700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US
V. Phone/Fax
- Phone: 614-293-6529
- Fax: 614-293-9469
- Phone: 614-293-6529
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | 34.015846 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | OS20784 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: