Provider Demographics
NPI:1588859201
Name:NIRANJAN SHASHIKANT PATEL,M.D., A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:NIRANJAN SHASHIKANT PATEL,M.D., A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:PINEVILLE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRANJAN
Authorized Official - Middle Name:SHASHIKANT
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-767-2222
Mailing Address - Street 1:3113 HWY 28 E
Mailing Address - Street 2:SUITE E
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-5758
Mailing Address - Country:US
Mailing Address - Phone:318-767-2222
Mailing Address - Fax:318-767-2264
Practice Address - Street 1:3113 HWY 28 E
Practice Address - Street 2:SUITE E
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-5758
Practice Address - Country:US
Practice Address - Phone:318-767-2222
Practice Address - Fax:318-767-2264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty