Individual
LEELA K PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
401 DIVISION ST, SUITE 306, SOUTH CHARLESTON, WV 25309-1455
(304) 766-4300
Mailing address
3 CLAYMONT RD, CHARLESTON, WV 25304-2767
(304) 344-0850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18983
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720355
MS BCBS
WV
05
—
0055016000
—
WV
01
—
080143242
RR MEDICARE
WV
01
—
5632473
AETNA
WV
Enumeration date
03/14/2006
Last updated
12/13/2012
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