Provider Demographics
NPI:1386708980
Name:PATEL, KANUBHAI C (MD)
Entity type:Individual
Prefix:MR
First Name:KANUBHAI
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3745 WHIPPLE AVE NW
Mailing Address - Street 2:SUITE A
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2933
Mailing Address - Country:US
Mailing Address - Phone:330-493-3313
Mailing Address - Fax:330-496-6413
Practice Address - Street 1:3745 WHIPPLE AVE NW
Practice Address - Street 2:SUITE A
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2933
Practice Address - Country:US
Practice Address - Phone:330-493-3313
Practice Address - Fax:330-496-6413
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35039686P2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0320423Medicaid
OHPA0425642Medicare ID - Type Unspecified
OH0320423Medicaid