MEDICARE: PIYUSH K 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	D00056345	MD

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	:	1669482964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIYUSH K PATEL MD

Provider Business Mailing Address
First Line	:	19745 EXECUTIVE PARK CIR
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-2642
Country	:	US
Telephone Number	:	301-946-6623
Fax Number	:	301-540-9448

Provider Business Practice Location Address
First Line	:	19703 EXECUTIVE PARK CIR
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-2639
Country	:	US
Telephone Number	:	301-946-6623
Fax Number	:	301-540-9448

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	01/31/2019

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