Provider Demographics
NPI:1093770018
Name:PATEL, HARSHAD
Entity Type:Individual
Prefix:
First Name:HARSHAD
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 1:207 E GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-6218
Mailing Address - Country:US
Mailing Address - Phone:256-413-1333
Mailing Address - Fax:256-413-0078
Practice Address - Street 1:207 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-6218
Practice Address - Country:US
Practice Address - Phone:256-413-1333
Practice Address - Fax:256-413-0078
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20610207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51032301OtherBCBS
AL000032301Medicaid
AL51032301OtherBCBS
F77682Medicare UPIN