Provider Demographics
NPI:1730434291
Name:PATEL, RISHIN (MD)
Entity type:Individual
Prefix:
First Name:RISHIN
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 9TH ST NE
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-3419
Mailing Address - Country:US
Mailing Address - Phone:330-745-3514
Mailing Address - Fax:330-745-5066
Practice Address - Street 1:290 9TH ST NE
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-3419
Practice Address - Country:US
Practice Address - Phone:330-745-3514
Practice Address - Fax:330-745-5066
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57020961207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0124960Medicaid
OH0124960Medicaid