MEDICARE: KAMAL PATEL MD

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	207P00000X	Emergency Medicine Physician	MA40632	NJ

General Provider Information

NPI Number	:	1417997511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMAL PATEL MD

Provider Business Mailing Address
First Line	:	1217 JACKSONVILLE RD
Second Line	:
City	:	MANSFIELD
State	:	NJ
Zip	:	08022-1931
Country	:	US
Telephone Number	:	609-291-0009
Fax Number	:

Provider Business Practice Location Address
First Line	:	1517 RICHMOND AVE
Second Line	:
City	:	POINT PLEASANT BEACH
State	:	NJ
Zip	:	08742-3056
Country	:	US
Telephone Number	:	732-206-8241
Fax Number	:

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	07/08/2007

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