MEDICARE: ANISH PATEL

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	390200000X	Student in an Organized Health Care Education/Training Program
2	208800000X	Urology Physician	DR.0077503	CO

General Provider Information

NPI Number	:	1629605027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANISH PATEL

Provider Business Mailing Address
First Line	:	10200 GRAND CENTRAL AVE STE 220
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-4366
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	799 E HAMPDEN AVE STE 310
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80113-2766
Country	:	US
Telephone Number	:	303-586-9495
Fax Number	:

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

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	05/13/2026

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Directions to “ ANISH PATEL ” Practice Location

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