Individual
DR. PRAKASH MAGANBHAI PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
800 GRAND CENTRAL MALL STE 6, VIENNA, WV 26105-4100
(304) 424-4531
(304) 424-4476
Mailing address
800 GRAND CENTRAL MALL STE 6, VIENNA, WV 26105-4100
(304) 424-4531
(304) 424-4476
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A047816
CA
208000000X
Pediatrics Physician
Primary
WV16490
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0107094000
—
WV
Enumeration date
09/20/2005
Last updated
10/25/2019
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