MEDICARE: DR. SUNDIP S PATEL D.O.

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	208800000X	Urology Physician	1524	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	102I345019	OTHER	AL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	511-74662	OTHER	AL	BCBS OF AL

General Provider Information

NPI Number	:	1487857025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUNDIP S PATEL D.O.

Provider Business Mailing Address
First Line	:	PO BOX 8427
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27835-8427
Country	:	US
Telephone Number	:	252-847-2181
Fax Number	:

Provider Business Practice Location Address
First Line	:	2119 E SOUTH BLVD
Second Line	:	SUITE 200
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-2454
Country	:	US
Telephone Number	:	334-613-7070
Fax Number	:	334-613-7072

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

Provider Enumeration Date	:	06/11/2007
Last Update Date	:	09/26/2019

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Directions to “ DR. SUNDIP S PATEL D.O.” Practice Location

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