Healthcare Provider Details

I. General information

NPI: 1154593168
Provider Name (Legal Business Name): DEEP VINU PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8400 N RUN MEDICAL DR STE 200
MECHANICSVILLE VA
23116-2319
US

IV. Provider business mailing address

8400 N RUN MEDICAL DR STE 200
MECHANICSVILLE VA
23116-2319
US

V. Phone/Fax

Practice location:
  • Phone: 804-559-6980
  • Fax: 804-559-6982
Mailing address:
  • Phone: 804-559-3980
  • Fax: 804-559-6982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number0101249866
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: