Provider Demographics
NPI:1215914650
Name:PATEL, NAREN M (MD)
Entity type:Individual
Prefix:
First Name:NAREN
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7972 W JEFFERSON BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-4140
Mailing Address - Country:US
Mailing Address - Phone:260-459-1780
Mailing Address - Fax:260-459-2779
Practice Address - Street 1:7972 W JEFFERSON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-4140
Practice Address - Country:US
Practice Address - Phone:260-459-1780
Practice Address - Fax:260-459-2779
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2016-06-21
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Provider Licenses
StateLicense IDTaxonomies
IN01029039207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100337700Medicaid
IN260660004Medicare PIN
IND67795Medicare UPIN
IN100337700Medicaid