| Kishor Patel Md Llc | |
|
21851 Center Ridge Rd 405 Rocky River OH 44116-3976 | |
| (440) 333-5822 | |
| (440) 333-5824 |
| Full Name | Kishor Patel Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 21851 Center Ridge Rd, Rocky River, Ohio |
| Authorized Official Name and Position | Kishor Patel (DIRECT OWNER) |
| Authorized Official Contact | 2162622050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kishor Patel Md Llc 21851 Center Ridge Rd 405 Rocky River OH 44116-3976 Ph: (440) 333-5822 | Kishor Patel Md Llc 21851 Center Ridge Rd 405 Rocky River OH 44116-3976 Ph: (440) 333-5822 |
| NPI Number | 1710563028 |
|---|---|
| Provider Enumeration Date | 03/18/2021 |
| Last Update Date | 09/20/2023 |
| Medicare PECOS PAC ID | 9638563406 |
|---|---|
| Medicare Enrollment ID | O20220222001737 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710563028 | NPI | - | NPPES |
| 0814855 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kishor P Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073613626 PECOS PAC ID: 0446245948 Enrollment ID: I20040415000455 |
| Provider Name | Mary E Klecka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942564802 PECOS PAC ID: 5294971057 Enrollment ID: I20151105002638 |
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