=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063533495
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PINA MAGANLAL PATEL MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2007
-----------------------------------------------------
Last Update Date | 01/05/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2050 KENNY RD
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43221-3502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-293-2957
-----------------------------------------------------
Fax | 614-685-6533
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 800 MCCONNELL DR
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43214-3463
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-566-5377
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | 35.098541
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RH0002X
-----------------------------------------------------
Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number | 35.098541
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------