Basic Information
| Provider Information | |||||||||
| NPI: | 1841611944 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | DEEPAK | ||||||||
| MiddleName: | G. | ||||||||
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| Credential: | M.D., M.P.H. | ||||||||
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| Mailing Information | |||||||||
| Address1: | P. O. BOX 123 | ||||||||
| Address2: | |||||||||
| City: | WICKLIFFE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44092 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168665279 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7007 POWERS BLVD | ||||||||
| Address2: | |||||||||
| City: | PARMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441295437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4407433000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2013 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 129416 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.