Provider Demographics
NPI:1366419202
Name:PATEL, SUNIL V (MD)
Entity type:Individual
Prefix:
First Name:SUNIL
Middle Name:V
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3020 HAMAKER COURT
Mailing Address - Street 2:SUITE B-111
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2220
Mailing Address - Country:US
Mailing Address - Phone:703-876-0288
Mailing Address - Fax:703-876-0290
Practice Address - Street 1:3020 HAMAKER COURT
Practice Address - Street 2:SUITE B-111
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2220
Practice Address - Country:US
Practice Address - Phone:703-876-0288
Practice Address - Fax:703-876-0290
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101236235208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAI16235Medicare UPIN
DC04894A80Medicare PIN