Healthcare Provider Details

I. General information

NPI: 1861566606
Provider Name (Legal Business Name): TUSHAR C PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 12/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 PURCHASE ST
NEW BEDFORD MA
02740
US

IV. Provider business mailing address

459 PLYMOUTH AVE
FALL RIVER MA
02721
US

V. Phone/Fax

Practice location:
  • Phone: 508-997-2900
  • Fax: 508-991-4432
Mailing address:
  • Phone: 508-679-0010
  • Fax: 508-672-4679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number51540
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number51540
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: