Healthcare Provider Details

I. General information

NPI: 1801358031
Provider Name (Legal Business Name): KRUTEN M PATEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2019
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 GREEN VALLEY RD
NEW ALBANY IN
47150-4645
US

IV. Provider business mailing address

119 OAKFIELD DR
BRANDON FL
33511-5779
US

V. Phone/Fax

Practice location:
  • Phone: 812-948-2232
  • Fax: 812-945-0869
Mailing address:
  • Phone: 813-681-5551
  • Fax: 813-916-2944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number02008934A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: