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General NPI Number Information
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NPI Number | 1235151705
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Entity Type | Individual
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Provider Name | SURESH K PATEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 06/19/2013
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Provider Practice Location Address
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Address Line | 909 2ND ST
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City | LANGDON
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State | ND
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Zip | 58249-2407
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Country | US
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Telephone | 701-256-6100
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Fax | 701-256-6156
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Provider Business Mailing Address
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Address Line | 909 2ND STREET
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City | LANGDON
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State | ND
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Zip | 58249
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Country | US
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Telephone | 701-256-6100
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Fax | 701-256-6156
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4196
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License Number State | ND
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