Provider Demographics
NPI:1366442261
Name:PATEL, UPENDRA H (MD)
Entity Type:Individual
Prefix:
First Name:UPENDRA
Middle Name:H
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 1:1040 SIERRA DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7240
Mailing Address - Country:US
Mailing Address - Phone:317-528-4886
Mailing Address - Fax:317-859-8239
Practice Address - Street 1:8242 CALUMET AVE.
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1704
Practice Address - Country:US
Practice Address - Phone:219-836-6166
Practice Address - Fax:219-836-0768
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01026776A207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100157570Medicaid
E33856Medicare UPIN
IN100157570Medicaid