Healthcare Provider Details

I. General information

NPI: 1336298413
Provider Name (Legal Business Name): BHARAT G. PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 09/02/2021
Certification Date: 09/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 STANAFORD RD
BECKLEY WV
25801-3142
US

IV. Provider business mailing address

PO BOX 941
BECKLEY WV
25802-0941
US

V. Phone/Fax

Practice location:
  • Phone: 304-553-3964
  • Fax: 681-207-1811
Mailing address:
  • Phone: 304-553-3964
  • Fax: 681-207-1811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number18661
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: