Healthcare Provider Details

I. General information

NPI: 1780684191
Provider Name (Legal Business Name): TRUPTI PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21035 SYCOLIN ROAD, SUITE 180
ASHBURN VA
20147-4311
US

IV. Provider business mailing address

224D CORNWALL ST NW STE 403
LEESBURG VA
20176-2704
US

V. Phone/Fax

Practice location:
  • Phone: 703-783-5673
  • Fax: 703-297-8100
Mailing address:
  • Phone: 703-737-6001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number0101236469
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101236469
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: