Provider Demographics
NPI:1558395046
Name:PATEL, DEVANG G (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVANG
Middle Name:G
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:906 OAK TREE AVE
Mailing Address - Street 2:SUITE J
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5127
Mailing Address - Country:US
Mailing Address - Phone:908-755-9993
Mailing Address - Fax:908-755-9994
Practice Address - Street 1:906 OAK TREE AVE
Practice Address - Street 2:SUITE J
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5127
Practice Address - Country:US
Practice Address - Phone:908-755-9993
Practice Address - Fax:908-755-9994
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA 71445207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0008788Medicaid
H05069Medicare UPIN
NJ0008788Medicaid