Provider Demographics
NPI:1629070826
Name:PATEL, UMESH A (MD, FACC)
Entity Type:Individual
Prefix:DR
First Name:UMESH
Middle Name:A
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1810 LINDBERG DR STE 2100
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-8064
Mailing Address - Country:US
Mailing Address - Phone:985-649-2700
Mailing Address - Fax:985-649-8488
Practice Address - Street 1:39 STARBRUSH CIR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7304
Practice Address - Country:US
Practice Address - Phone:985-871-4155
Practice Address - Fax:985-871-4483
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA07406R207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00112332Medicaid
LA1396044Medicaid
LA5L986Medicare ID - Type Unspecified
LA1396044Medicaid