Provider Demographics
NPI:1861483695
Name:PATEL, NAINESH M (MD)
Entity type:Individual
Prefix:MR
First Name:NAINESH
Middle Name:M
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:PO BOX 787
Mailing Address - Street 2:
Mailing Address - City:CRAB ORCHARD
Mailing Address - State:WV
Mailing Address - Zip Code:25827-0787
Mailing Address - Country:US
Mailing Address - Phone:304-253-5793
Mailing Address - Fax:304-253-0166
Practice Address - Street 1:207 SUNSET DR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2825
Practice Address - Country:US
Practice Address - Phone:304-255-5723
Practice Address - Fax:304-929-3953
Is Sole Proprietor?:No
Enumeration Date:2005-11-01
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV19985174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV6000475000Medicaid
WVP00089431OtherRR MCARE
WV001722660OtherBC
WVP00089431OtherRR MCARE
WVH06020Medicare UPIN