Provider Demographics
NPI:1629023726
Name:PATEL, BHARATI V (MD)
Entity Type:Individual
Prefix:DR
First Name:BHARATI
Middle Name:V
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 NORTHCOTE AVE
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2726
Mailing Address - Country:US
Mailing Address - Phone:219-923-4567
Mailing Address - Fax:
Practice Address - Street 1:315 W 89TH AVE
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6254
Practice Address - Country:US
Practice Address - Phone:219-757-5275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01032188A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100323930Medicaid
IN000000586158OtherANTHEM
INP00140384OtherRR MEDICARE
INP00140384OtherRR MEDICARE
IN258070Medicare PIN