Provider Demographics
NPI:1639276934
Name:PATEL, MUKESHBHAI B (MD)
Entity Type:Individual
Prefix:
First Name:MUKESHBHAI
Middle Name:B
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 1:5419 N LOVINGTON HWY
Mailing Address - Street 2:SUITE 7
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-9100
Mailing Address - Country:US
Mailing Address - Phone:732-713-2824
Mailing Address - Fax:575-392-3911
Practice Address - Street 1:5419 N LOVINGTON HWY
Practice Address - Street 2:SUITE 7
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-9100
Practice Address - Country:US
Practice Address - Phone:732-713-2824
Practice Address - Fax:575-392-3911
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2014-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2011-0830207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNMAAA2579Medicare PIN