Basic Information
| Provider Information | |||||||||
| NPI: | 1235579756 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | PAUL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1620 COOPER POINT RD SW | ||||||||
| Address2: | MA303, DC032.00 | ||||||||
| City: | OLYMPIA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985025736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738842912 | ||||||||
| FaxNumber: | 5738844122 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 N HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | FULTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652512511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5736425911 | ||||||||
| FaxNumber: | 5736423015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2013 | ||||||||
| LastUpdateDate: | 06/23/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD60658462 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.