Provider Demographics
NPI:1326123423
Name:PATEL, AMI R (MD)
Entity Type:Individual
Prefix:DR
First Name:AMI
Middle Name:R
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:102 RIVERVIEW DR
Mailing Address - Street 2:STE A
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-8908
Mailing Address - Country:US
Mailing Address - Phone:601-981-1610
Mailing Address - Fax:601-366-2887
Practice Address - Street 1:102 RIVERVIEW DR
Practice Address - Street 2:STE A
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8908
Practice Address - Country:US
Practice Address - Phone:601-981-1610
Practice Address - Fax:601-366-2887
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS13293207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00119897Medicaid
MS302I112894Medicare PIN
MS00119897Medicaid