Individual
SANJIV P PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2960 MACK RD STE 200, FAIRFIELD, OH 45014-5300
(513) 774-2870
(513) 774-2633
Mailing address
2960 MACK RD STE 200, FAIRFIELD, OH 45014-5300
(513) 774-2870
(513) 774-2727
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35.073242
OH
207RP1001X
Pulmonary Disease Physician
35073242
OH
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
35.073242
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000329261
BCBS OHIO
—
05
—
2517495
—
OH
01
—
311138782028
CARESOURCE
—
01
—
P00145359
RAILROAD MEDICARE
—
Enumeration date
02/10/2006
Last updated
12/03/2020
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