Basic Information
Provider Information
NPI: 1922218924
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: MIHIR
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 64442
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212644442
CountryCode: US
TelephoneNumber: 4103288040
FaxNumber: 4434623514
Practice Location
Address1: 419 W REDWOOD ST
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212011734
CountryCode: US
TelephoneNumber: 6672141515
FaxNumber: 4103283826
Other Information
ProviderEnumerationDate: 05/22/2007
LastUpdateDate: 09/03/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/03/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD042289DCN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000XD89426MDN Allopathic & Osteopathic PhysiciansHospitalist 
207R00000XD89426MDY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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