Basic Information
| Provider Information | |||||||||
| NPI: | 1780837880 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | MITA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41201 SCHADDEN RD | ||||||||
| Address2: | |||||||||
| City: | ELYRIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440352249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4409348344 | ||||||||
| FaxNumber: | 4403948345 | ||||||||
| Practice Location | |||||||||
| Address1: | 41201 SCHADDEN RD | ||||||||
| Address2: | |||||||||
| City: | ELYRIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440352249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4409348344 | ||||||||
| FaxNumber: | 4403948345 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2008 | ||||||||
| LastUpdateDate: | 12/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 35.095317 | OH | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.