Healthcare Provider Details
I. General information
NPI: 1164728820
Provider Name (Legal Business Name): ROMIL Y PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/28/2011
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
703 RIVERWAY PL STE 115
BEDFORD NH
03110-6745
US
IV. Provider business mailing address
703 RIVERWAY PL STE 115
BEDFORD NH
03110-6768
US
V. Phone/Fax
- Phone: 603-627-1661
- Fax: 603-669-6944
- Phone: 603-627-1661
- Fax: 603-669-6944
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RM1200X |
| Taxonomy | Magnetic Resonance Imaging (MRI) Internal Medicine Physician |
| License Number | ME110292 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | ME110292 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 23922 |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: