Individual
DR. PRAVIN I PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1322 LOCUST AVE, FAIRMONT, WV 26554
(304) 366-0700
(304) 366-9529
Mailing address
1322 LOCUST AVE, PO BOX 1112, FAIRMONT, WV 26554
(304) 366-0700
(304) 366-9529
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10239
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000058954
MT STATE BC/BS
WV
01
—
0004420446
AETNA
WV
05
—
0082810000
—
WV
01
—
0573008
HOME PLAN PEIA AND CHIPS
WV
01
—
110087720
RR MEDICARE
WV
01
—
505819
NATIONAL CAPITAL PPO
WV
01
—
E19547
WV WORKER'S COMP
WV
01
—
FQ10239
HEALTH PLAN
WV
Enumeration date
07/07/2006
Last updated
08/11/2011
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