Provider Demographics
NPI:1659416303
Name:HARSHAD PATEL MD PC
Entity Type:Organization
Organization Name:HARSHAD PATEL MD PC
Other - Org Name:ETOWAH CENTER FOR INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HARSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-413-1333
Mailing Address - Street 1:207 EAST GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-6218
Mailing Address - Country:US
Mailing Address - Phone:256-413-1333
Mailing Address - Fax:256-413-0078
Practice Address - Street 1:207 EAST GRAND AVE
Practice Address - Street 2:
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-6218
Practice Address - Country:US
Practice Address - Phone:256-413-1333
Practice Address - Fax:256-413-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20610207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000032301Medicaid
AL51032301OtherBCBS
AL51032301OtherBCBS
AL000032301Medicaid