Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 005450 | GA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 01078745A | IN |
N | 207RH0002X | Hospice and Palliative Medicine | 2016-02019 | NC |
NPI | 1306106455 |
---|---|
Provider Name | Ami V Patel |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Fishers, IN 46037-4154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2012 |
Last Update Date | 27/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
074297 | GA LICENSE (01) | GA |
1306106455 | (05) | NC |
NC2896 | (05) | SC |