MEDICARE: KHUSBU PATEL DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	2022025229	MO

General Provider Information

NPI Number	:	1194389031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHUSBU PATEL DPM

Provider Business Mailing Address
First Line	:	385 TREMONT AVE
Second Line	:
City	:	EAST ORANGE
State	:	NJ
Zip	:	07018-1023
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1455 US HIGHWAY 61 STE A
Second Line	:
City	:	FESTUS
State	:	MO
Zip	:	63028-4158
Country	:	US
Telephone Number	:	636-223-4639
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2019
Last Update Date	:	08/15/2022

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Directions to “ KHUSBU PATEL DPM” Practice Location

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