Provider Demographics
NPI:1598150880
Name:PATEL, RONAK (MD)
Entity Type:Individual
Prefix:
First Name:RONAK
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1633 N CAPITOL AVE STE 640
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-1281
Mailing Address - Country:US
Mailing Address - Phone:317-962-8881
Mailing Address - Fax:317-962-0838
Practice Address - Street 1:1633 N CAPITOL AVE STE 640
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1281
Practice Address - Country:US
Practice Address - Phone:317-962-8881
Practice Address - Fax:317-962-0838
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
TXS0770207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program