Healthcare Provider Details

I. General information

NPI: 1992011068
Provider Name (Legal Business Name): HARSHAD M PATEL M.D. APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2010
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4216 FLORIDA AVE
KENNER LA
70065-1360
US

IV. Provider business mailing address

4216 FLORIDA AVE
KENNER LA
70065-1360
US

V. Phone/Fax

Practice location:
  • Phone: 504-466-3702
  • Fax: 504-468-9374
Mailing address:
  • Phone: 504-466-3702
  • Fax: 504-468-9374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberMD 09704R
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD 09704R
License Number StateLA

VIII. Authorized Official

Name: DR. HARSHADBHAI MANIBHAI PATEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 504-466-3702