Healthcare Provider Details

I. General information

NPI: 1104245737
Provider Name (Legal Business Name): KRUPA HASMUKH PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2014
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 18TH ST S STE 601
BIRMINGHAM AL
35233-3800
US

IV. Provider business mailing address

P.O. BOX 830941 MSC# 559
BIRMINGHAM AL
35283
US

V. Phone/Fax

Practice location:
  • Phone: 205-325-8620
  • Fax:
Mailing address:
  • Phone: 205-325-8536
  • Fax: 205-325-8270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number38634
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: