Provider Demographics
NPI:1154395689
Name:PATEL, KAMINI P (MD)
Entity type:Individual
Prefix:
First Name:KAMINI
Middle Name:P
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9316 PARAGON MILLS LN
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-4184
Mailing Address - Country:US
Mailing Address - Phone:937-304-8551
Mailing Address - Fax:
Practice Address - Street 1:9316 PARAGON MILLS LN
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-4184
Practice Address - Country:US
Practice Address - Phone:937-304-8551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35085214207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2608726Medicaid
OH2608726Medicaid
OHI44768Medicare UPIN