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General NPI Number Information
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NPI Number | 1235325085
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Entity Type | Organization
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Legal Business Name | KANTILAL S. PATEL M.D.
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 525 W CHICAGO AVE
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City | EAST CHICAGO
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State | IN
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Zip | 46312-3206
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Country | US
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Telephone | 219-397-1342
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Fax | 219-397-2580
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Provider Business Mailing Address
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Address Line | 525 W CHICAGO AVE
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City | EAST CHICAGO
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State | IN
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Zip | 46312-3206
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Country | US
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Telephone | 219-397-1342
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Fax | 219-397-2580
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. KANTILAL PATEL
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Credential | M.D.
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Telephone | 219-397-1342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01043474
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License Number State | IN
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