Provider Demographics
NPI:1396286662
Name:PATEL, AMI PIYUSH
Entity type:Individual
Prefix:
First Name:AMI
Middle Name:PIYUSH
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 N GEORGE MASON DR STE 3A
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-1953
Mailing Address - Country:US
Mailing Address - Phone:703-717-4792
Mailing Address - Fax:
Practice Address - Street 1:1851 N. GEORGE MASON DRIVE
Practice Address - Street 2:#3A
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207
Practice Address - Country:US
Practice Address - Phone:703-717-4792
Practice Address - Fax:703-717-4793
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102208008207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology