Healthcare Provider Details

I. General information

NPI: 1831369040
Provider Name (Legal Business Name): MITESH BABUBHAI PATEL M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MITESHKUMAR BABUBHAI PATEL M.D

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 ALLEQUIPPA ST
PITTSBURGH PA
15240-1002
US

IV. Provider business mailing address

6439 GARNERS FERRY RD WJB DORN VA
COLUMBIA SC
29209-1638
US

V. Phone/Fax

Practice location:
  • Phone: 803-243-9892
  • Fax:
Mailing address:
  • Phone: 803-776-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberFP2273097
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125048979
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number2012010194
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: