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General NPI Number Information
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NPI Number | 1366436412
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Entity Type | Individual
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Provider Name | BHUPENDRA C PATEL M.D., F.R.C.S.
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Gender | Male
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 65 NORTH MEDICAL DRIVE
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City | SALT LAKE CITY
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State | UT
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Zip | 84132
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Country | US
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Telephone | 801-581-2352
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Fax |
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Provider Business Mailing Address
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Address Line | 65 N MEDICAL DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84132-1000
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Country | US
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Telephone | 801-585-6641
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 188029-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 207WX0200X
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Taxonomy Name | Ophthalmic Plastic and Reconstructive Surgery Physician
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License Number | 188029-1205
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 188029-1205
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License Number State | UT
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