Provider Demographics
NPI:1134133390
Name:PATEL, VINUBHAI (MD)
Entity Type:Individual
Prefix:
First Name:VINUBHAI
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 847201
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-7201
Mailing Address - Country:US
Mailing Address - Phone:508-698-3288
Mailing Address - Fax:508-698-3277
Practice Address - Street 1:70 WALNUT ST
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-5312
Practice Address - Country:US
Practice Address - Phone:508-698-3288
Practice Address - Fax:508-698-3277
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA397172085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAC24026OtherBLUE SHIELD
MA2056178Medicaid
MA24732OtherHARVARD PILGRIM
MA039717OtherTUFTS HEALTH PLAN
MA039717OtherTUFTS HEALTH PLAN
MA24732OtherHARVARD PILGRIM