Healthcare Provider Details

I. General information

NPI: 1730186032
Provider Name (Legal Business Name): BHARAT K PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 01/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 DIAGONAL RD
WORTHINGTON MN
56187-1008
US

IV. Provider business mailing address

PO BOX 5074
SIOUX FALLS SD
57117-5074
US

V. Phone/Fax

Practice location:
  • Phone: 507-372-3800
  • Fax: 507-372-3806
Mailing address:
  • Phone: 605-328-9556
  • Fax: 605-328-9501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number49839
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number46486
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: