Provider Demographics
NPI:1205127172
Name:PATEL, VISHAL R (MD MBA)
Entity type:Individual
Prefix:DR
First Name:VISHAL
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 WELDIN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3974
Mailing Address - Country:US
Mailing Address - Phone:302-440-4275
Mailing Address - Fax:302-623-0275
Practice Address - Street 1:2300 PENNSYLVANIA AVE STE 4C
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-1338
Practice Address - Country:US
Practice Address - Phone:302-440-4275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-27
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0079030207R00000X
PAD79030207R00000X
DEC1-0010457208000000X, 207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics