Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 0424301 | KS |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 102052 | MO |
N | 2081P2900X | Pain Medicine | 0424301 | KS |
N | 2081P2900X | Pain Medicine | 102052 | MO |
NPI | 1306874854 |
---|---|
Provider Name | Atul T Patel |
First Address | Saint Louis, MO 63128-2786 |
Second Address | Overland Park, KS 66211-1231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 29/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
18742069 | BCBS KC (01) | |
18742069 | BCBS OTHER (01) | |
F43003 | (02) | |
P0149716 | RAILROAD MEDICARE (01) |