MEDICARE: AJAY T PATEL MD INC

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	20391	WV

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	:	1710029715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AJAY T PATEL MD INC

Provider Business Mailing Address
First Line	:	450 2ND ST
Second Line	:
City	:	SAINT ALBANS
State	:	WV
Zip	:	25177-2857
Country	:	US
Telephone Number	:	304-727-0016
Fax Number	:	304-727-2929

Provider Business Practice Location Address
First Line	:	450 2ND ST
Second Line	:
City	:	SAINT ALBANS
State	:	WV
Zip	:	25177-2857
Country	:	US
Telephone Number	:	304-727-0016
Fax Number	:	304-727-2929

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	DR. AJAY PATEL
Credential	:
Telephone Number	:	304-727-0016

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	10/24/2007

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