Provider Demographics
NPI:1447299003
Name:PATEL, MINESH SUMAN (DC)
Entity type:Individual
Prefix:DR
First Name:MINESH
Middle Name:SUMAN
Last Name:PATEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3660 BOULEVARD
Mailing Address - Street 2:SUITE G
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-1345
Mailing Address - Country:US
Mailing Address - Phone:804-526-7125
Mailing Address - Fax:804-520-7624
Practice Address - Street 1:3660 BOULEVARD
Practice Address - Street 2:SUITE G
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-1345
Practice Address - Country:US
Practice Address - Phone:804-526-7125
Practice Address - Fax:804-520-7624
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556158111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU95498Medicare UPIN
VA00V902A01Medicare ID - Type Unspecified