Provider Demographics
NPI:1326047655
Name:PATEL, BHUPENDRA M (MD)
Entity Type:Individual
Prefix:DR
First Name:BHUPENDRA
Middle Name:M
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 1:8375 DIX ELLIS TRL STE 201
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-8241
Mailing Address - Country:US
Mailing Address - Phone:877-276-9842
Mailing Address - Fax:
Practice Address - Street 1:RAI
Practice Address - Street 2:2501 KUSER ROAD
Practice Address - City:HAMITON TOWENSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08691
Practice Address - Country:US
Practice Address - Phone:609-585-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1646332085R0202X
FLMD1646332085R0202X
NJ25MA052433002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA182757OtherHIGHMARK PA BLUE SHIELD
300124858OtherRAILROAD MEDICARE
1156587OtherHORIZON NJ HEALTH
2653639OtherAETNA
NJ3717500Medicaid
0229318000OtherAMERIHEALTH
A3738029OtherOXFORD HEALTH
PA182757OtherHIGHMARK PA BLUE SHIELD
NJ3717500Medicaid