Provider Demographics
NPI:1447574132
Name:INFECTIOUS DISEASE CONSULTANTS LLC
Entity Type:Organization
Organization Name:INFECTIOUS DISEASE CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SWETAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:319-621-4345
Mailing Address - Street 1:1 NASSAU ST
Mailing Address - Street 2:UNIT 305
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1542
Mailing Address - Country:US
Mailing Address - Phone:319-621-4345
Mailing Address - Fax:502-526-4565
Practice Address - Street 1:1 NASSAU ST
Practice Address - Street 2:UNIT 305
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1542
Practice Address - Country:US
Practice Address - Phone:319-621-4345
Practice Address - Fax:502-526-4565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231268207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA231268OtherMEDICAL LICENSE