Provider Demographics
NPI:1578576286
Name:PATEL, ALKESH V (MD)
Entity Type:Individual
Prefix:DR
First Name:ALKESH
Middle Name:V
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 1:710 MAIN STREET
Mailing Address - Street 2:BUILDING 1
Mailing Address - City:PLANTSVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06479
Mailing Address - Country:US
Mailing Address - Phone:860-276-8453
Mailing Address - Fax:860-736-0028
Practice Address - Street 1:710 MAIN STREET
Practice Address - Street 2:BUILDING 1
Practice Address - City:PLANTSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06479
Practice Address - Country:US
Practice Address - Phone:860-276-8453
Practice Address - Fax:860-736-0028
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038981207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001389817Medicaid
110008505Medicare ID - Type Unspecified
CT001389817Medicaid