Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 17871 | KY |
NPI | 1043389885 |
---|---|
Provider Name | Mahendra M Patel |
First Address | Elizabethtown, KY 42701-8437 |
Second Address | Elizabethtown, KY 42701-8437 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 22/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64178718 | (05) | KY |
C70996 | (02) | KY |