MEDICARE: MANISHA AMI 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	208600000X	Surgery Physician	37777	KY
2	208600000X	Surgery Physician	35081783P	OH
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	042-0017034	VT
4	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	37777	KY
5	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	35081783P	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	310804060036	OTHER	CARESOURCE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000245368	OTHER	ANTHEM
5	1800452	OTHER	UNITED HEALTHCARE
6	81783	OTHER	CHOICE CARE/HUMANA
7	8330	OTHER	KY BCBS

General Provider Information

NPI Number	:	1629002076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANISHA AMI PATEL M.D.

Provider Business Mailing Address
First Line	:	4750 E GALBRAITH RD STE 215
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-6706
Country	:	US
Telephone Number	:	513-421-3494
Fax Number	:	513-345-2606

Provider Business Practice Location Address
First Line	:	4750 E GALBRAITH RD STE 215
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-6706
Country	:	US
Telephone Number	:	513-421-3494
Fax Number	:	513-345-2606

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	02/13/2024

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Directions to “ MANISHA AMI PATEL M.D.” Practice Location

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