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MANALI R PATEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3636 HIGH ST, PORTSMOUTH, VA 23707
(757) 650-2725
(770) 573-9513
Mailing address
3636 HIGH ST, PORTSMOUTH, VA 23707-3236
(757) 650-2725
(770) 573-9513

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
0101248147
VA
207RI0200X
Infectious Disease Physician
TP859
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0101248147
BOARD OF MEDICINE LICENSE TO PRACTICE
VA
01
01062888A
INDIANA MEDICAL LICENSE
IN
01
TP859
KY MEDICAL LICENSE
KY
Enumeration date
11/01/2006
Last updated
08/16/2024
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