Provider Demographics
NPI:1679732846
Name:PATEL, SAMIR MAHADEVBHAI (MBBS, MPH)
Entity Type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:MAHADEVBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MBBS, MPH
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Mailing Address - Street 1:285 GOVERNOR ST STE 250
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3237
Mailing Address - Country:US
Mailing Address - Phone:019-924-7024
Mailing Address - Fax:425-242-3686
Practice Address - Street 1:285 GOVERNOR ST STE 250
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3237
Practice Address - Country:US
Practice Address - Phone:019-924-7024
Practice Address - Fax:425-242-3686
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD141362084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry