Provider Demographics
NPI:1972543635
Name:PATEL, SEEMA M (MD)
Entity type:Individual
Prefix:
First Name:SEEMA
Middle Name:M
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 1:38740 GAELIC GLN
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-5933
Mailing Address - Country:US
Mailing Address - Phone:215-490-2218
Mailing Address - Fax:
Practice Address - Street 1:1950 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-3719
Practice Address - Country:US
Practice Address - Phone:216-986-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD069295207Q00000X
OH35.083301207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01803744Medicaid
PA01803744Medicaid
PA01803744Medicaid