Provider Demographics
NPI:1700862240
Name:KANU J PATEL, MD
Entity Type:Organization
Organization Name:KANU J PATEL, MD
Other - Org Name:REGIONAL MEDICAL CENTER CLINICS
Other - Org Type:Other Name
Authorized Official - Title/Position:PHY PRACTICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-382-2681
Mailing Address - Street 1:45 MEDICAL ARTS COURT SUITE 1
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037
Mailing Address - Country:US
Mailing Address - Phone:334-382-5564
Mailing Address - Fax:
Practice Address - Street 1:45 MEDICAL ARTS COURT SUITE 1
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:AL
Practice Address - Zip Code:36037
Practice Address - Country:US
Practice Address - Phone:334-382-5564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HEALTH CARE AUTHORITY OF THE CITY OF GREENVILLE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-16
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19252207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009982410Medicaid
ALDN1376OtherRAILROAD MEDICARE
AL009982410Medicaid
AL051506986Medicare ID - Type Unspecified