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General NPI Number Information
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NPI Number | 1679732846
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Entity Type | Individual
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Provider Name | SAMIR MAHADEVBHAI PATEL MBBS, MPH
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Gender | Male
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 285 GOVERNOR ST STE 250
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City | PROVIDENCE
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State | RI
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Zip | 02906-3237
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Country | US
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Telephone | 19-924-7024
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Fax | 425-242-3686
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Provider Business Mailing Address
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Address Line | 285 GOVERNOR ST STE 250
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City | PROVIDENCE
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State | RI
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Zip | 02906-3237
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Country | US
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Telephone | 19-924-7024
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Fax | 425-242-3686
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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 | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | MD14136
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD14136
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License Number State | RI
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