MEDICARE: HITESH KESHAVBHAI PATEL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	053013	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00249957	OTHER	VA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174571541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HITESH KESHAVBHAI PATEL MD

Provider Business Mailing Address
First Line	:	7101 JAHNKE RD
Second Line	:	SUITE 611
City	:	RICHMOND
State	:	VA
Zip	:	23225-4017
Country	:	US
Telephone Number	:	804-327-4046
Fax Number	:	804-327-4047

Provider Business Practice Location Address
First Line	:	501 REDMOND RD NW
Second Line	:	6TH FLOOR
City	:	ROME
State	:	GA
Zip	:	30165-1415
Country	:	US
Telephone Number	:	706-368-8452
Fax Number	:	706-368-8453

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	11/15/2007

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