Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 01074712A | IN |
NPI | 1003078429 |
---|---|
Provider Name | Archana Patel |
First Address | Goshen, IN 46526-5236 |
Second Address | Goshen, IN 46526-5236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 15/12/2014 |