Provider Demographics
NPI:1568455293
Name:PATEL, JAIMINI RASIKLAL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIMINI
Middle Name:RASIKLAL
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 1:6716 E MANOR DR
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-9018
Mailing Address - Country:US
Mailing Address - Phone:812-299-9290
Mailing Address - Fax:
Practice Address - Street 1:6716 E MANOR DR
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-9018
Practice Address - Country:US
Practice Address - Phone:812-299-9290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-29
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01034813A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INA13575Medicare UPIN