Provider Demographics
NPI:1699740613
Name:PATEL, DHRUV R (MD)
Entity type:Individual
Prefix:DR
First Name:DHRUV
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 KOLBE RD STE 223
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1652
Mailing Address - Country:US
Mailing Address - Phone:440-222-4661
Mailing Address - Fax:440-222-4662
Practice Address - Street 1:3600 KOLBE RD STE 223
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1652
Practice Address - Country:US
Practice Address - Phone:440-222-4661
Practice Address - Fax:440-222-4662
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35072560P174400000X
OH35.0725602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH130019353OtherRAILROAD MEDICARE
OH2099698Medicaid
OH000000131156OtherANTHEM BCBS
OH000000131156OtherANTHEM BCBS
OHF74136Medicare UPIN