Provider Demographics
NPI:1871558452
Name:PATEL, HARSHAD P (MD)
Entity type:Individual
Prefix:
First Name:HARSHAD
Middle Name:P
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1100 E MICHIGAN
Mailing Address - Street 2:STE #307
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201
Mailing Address - Country:US
Mailing Address - Phone:517-783-2618
Mailing Address - Fax:517-783-2771
Practice Address - Street 1:1100 E MICHIGAN AVE
Practice Address - Street 2:STE #307
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1847
Practice Address - Country:US
Practice Address - Phone:517-783-2618
Practice Address - Fax:517-783-2771
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301065750207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOC810340OtherBSBC
MI3205941Medicaid
OM94070Medicare ID - Type Unspecified
MI3205941Medicaid