Provider Demographics
NPI:1801250964
Name:PATEL, DEVESH ARUN (MD)
Entity type:Individual
Prefix:DR
First Name:DEVESH
Middle Name:ARUN
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:600 GRESHAM DR STE 204
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1904
Mailing Address - Country:US
Mailing Address - Phone:757-388-5680
Mailing Address - Fax:757-388-5681
Practice Address - Street 1:600 GRESHAM DR STE 204
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1904
Practice Address - Country:US
Practice Address - Phone:757-388-5680
Practice Address - Fax:757-388-5681
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT211646207Q00000X
VA0101271560207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine