MEDICARE: MS. PAYAL BHARAT PATEL M.D.

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	2080P0008X	Pediatric Neurodevelopmental Disabilities Physician	MT205044	PA
2	2084N0400X	Neurology Physician	MD60964075	WA
3	2084P0005X	Neurodevelopmental Disabilities Physician	MD60964075	WA

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	:	1548551385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PAYAL BHARAT PATEL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 50095
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98145-5095
Country	:	US
Telephone Number	:	206-520-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	4800 SAND POINT WAY NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-3901
Country	:	US
Telephone Number	:	206-987-2000
Fax Number	:

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

Provider Enumeration Date	:	04/27/2011
Last Update Date	:	03/13/2020

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