Provider Demographics
NPI:1336313899
Name:PATEL, REBECCA SANDFORT (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:SANDFORT
Last Name:PATEL
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Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:332 HANOVER ST
Mailing Address - Street 2:MGH NORTH END COMMUNITY HEALTH CENTER
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02113-1901
Mailing Address - Country:US
Mailing Address - Phone:617-643-8000
Mailing Address - Fax:617-643-8184
Practice Address - Street 1:332 HANOVER ST
Practice Address - Street 2:MGH NORTH END COMMUNITY HEALTH CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02113-1901
Practice Address - Country:US
Practice Address - Phone:617-643-8000
Practice Address - Fax:617-643-8184
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2010-11-04
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Provider Licenses
StateLicense IDTaxonomies
MA243811207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA243811OtherMA FULL MEDICAL LICENSE