Provider Demographics
NPI:1699960856
Name:PATEL, MAHESH I (MD)
Entity type:Individual
Prefix:DR
First Name:MAHESH
Middle Name:I
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MAHESHKUMAR
Other - Middle Name:ISHWARLAL
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2110 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067
Mailing Address - Country:US
Mailing Address - Phone:860-258-3470
Mailing Address - Fax:860-571-6800
Practice Address - Street 1:80 SEYMOUR ST
Practice Address - Street 2:SOUTH 502/DIVISION OF HOSPITAL MEDICINE,CMG
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06102-8000
Practice Address - Country:US
Practice Address - Phone:860-972-6230
Practice Address - Fax:860-545-5221
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08308300207R00000X
CT046320282N00000X, 207R00000X
NHLT-2704282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30207834Medicaid
CT110010576Medicare PIN
NH000343601Medicare PIN