Provider Demographics
NPI:1083409411
Name:PATEL, DISHANT MANISHKUMAR (PA-C)
Entity type:Individual
Prefix:
First Name:DISHANT
Middle Name:MANISHKUMAR
Last Name:PATEL
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2863 GRAHAM RD APT 8
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-3674
Mailing Address - Country:US
Mailing Address - Phone:330-860-0107
Mailing Address - Fax:
Practice Address - Street 1:2863 GRAHAM RD APT 8
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-3674
Practice Address - Country:US
Practice Address - Phone:330-860-0107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant