Provider Demographics
NPI:1316531379
Name:PATEL, NARENDRAKUMAR
Entity type:Individual
Prefix:
First Name:NARENDRAKUMAR
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9802 WILDWOOD CIR APT 2A
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-3983
Mailing Address - Country:US
Mailing Address - Phone:219-916-9770
Mailing Address - Fax:
Practice Address - Street 1:9802 WILDWOOD CIR APT 2A
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3983
Practice Address - Country:US
Practice Address - Phone:219-916-9770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-21
Last Update Date:2021-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26023583A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist