Basic Information
| Provider Information | |||||||||
| NPI: | 1649477415 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | INDUBHAI | ||||||||
| MiddleName: | MANIBHAI | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 39 WATERMAN DR | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN TOP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 187079629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5707934443 | ||||||||
| FaxNumber: | 5708195176 | ||||||||
| Practice Location | |||||||||
| Address1: | 1111 E END BLVD | ||||||||
| Address2: | VA MEDICAL CENTER | ||||||||
| City: | PLAINS TWP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 187027923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708243521 | ||||||||
| FaxNumber: | 5708195176 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2007 | ||||||||
| LastUpdateDate: | 08/13/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD456684 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 25MA08233800 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.