Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | ME85416 | FL |
N | 207Q00000X | Family Doctor | ME85416 | FL |
N | 207U00000X | Nuclear Medicine Specialist | ME85416 | FL |
NPI | 1255416947 |
---|---|
Provider Name | Dr. Kamlesh Patel |
First Address | Fort Wayne, IN 46845-9373 |
Second Address | Fort Wayne, IN 46845-9373 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 30/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H01543 | (02) |