Healthcare Provider Details

I. General information

NPI: 1598519803
Provider Name (Legal Business Name): NIDHI S PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 W KINNICKINNIC RIVER PKWY STE 250
MILWAUKEE WI
53215-3678
US

IV. Provider business mailing address

26103 W 108TH TER
OLATHE KS
66061-7522
US

V. Phone/Fax

Practice location:
  • Phone: 414-649-6732
  • Fax:
Mailing address:
  • Phone: 816-807-5413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number8725020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: