Provider Demographics
NPI:1356304406
Name:J.N. PATEL, M.D. P.C.
Entity Type:Organization
Organization Name:J.N. PATEL, M.D. P.C.
Other - Org Name:MICHIANA MEDICAL-SURGICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JASHU
Authorized Official - Middle Name:N
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-782-2273
Mailing Address - Street 1:515 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DOWAGIAC
Mailing Address - State:MI
Mailing Address - Zip Code:49047-1710
Mailing Address - Country:US
Mailing Address - Phone:269-782-2273
Mailing Address - Fax:269-782-6682
Practice Address - Street 1:515 MAIN ST
Practice Address - Street 2:
Practice Address - City:DOWAGIAC
Practice Address - State:MI
Practice Address - Zip Code:49047-1710
Practice Address - Country:US
Practice Address - Phone:269-782-2273
Practice Address - Fax:269-782-6682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJP037662207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI233878Medicare Oscar/Certification