Provider Demographics
NPI:1104325026
Name:PATEL, URVISHKUMAR ASHOKBHAI (RPH)
Entity type:Individual
Prefix:
First Name:URVISHKUMAR
Middle Name:ASHOKBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14183 MOONLIGHT PATH
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-6640
Mailing Address - Country:US
Mailing Address - Phone:317-353-4156
Mailing Address - Fax:
Practice Address - Street 1:6330 E 75TH ST STE 322
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2708
Practice Address - Country:US
Practice Address - Phone:800-678-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15949183500000X
MI5302041329183500000X
TX51251183500000X
WVRP0008471183500000X
NE15285183500000X
MST-14415183500000X
AZS021080183500000X
IN26024411A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist