Provider Demographics
NPI:1275502668
Name:PATEL, PARESHA A (MD)
Entity Type:Individual
Prefix:DR
First Name:PARESHA
Middle Name:A
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:541 MAIN ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1868
Mailing Address - Country:US
Mailing Address - Phone:781-952-1280
Mailing Address - Fax:781-952-1570
Practice Address - Street 1:541 MAIN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1868
Practice Address - Country:US
Practice Address - Phone:781-952-1280
Practice Address - Fax:781-952-1570
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA226500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2111888Medicaid
MAAA46221OtherHARVARD PILGRIM
MAJ29362OtherBLUE CROSS BLUE SHIELD
MA494342OtherTUFTS HEALTH PLAN
MAA39536Medicare PIN
MAAA46221OtherHARVARD PILGRIM
MAH80827Medicare UPIN