Provider Demographics
NPI:1750331203
Name:PATEL, MINESH S (MD)
Entity Type:Individual
Prefix:
First Name:MINESH
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:900 CUMMINGS CTR
Mailing Address - Street 2:SUITE 221U
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6198
Mailing Address - Country:US
Mailing Address - Phone:978-927-7246
Mailing Address - Fax:978-927-7249
Practice Address - Street 1:900 CUMMINGS CTR
Practice Address - Street 2:SUITE 221U
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6198
Practice Address - Country:US
Practice Address - Phone:978-927-7246
Practice Address - Fax:978-927-7249
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2012-06-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA226296207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2122651Medicaid
MA2122651Medicaid
I56824Medicare UPIN
MAA4011401Medicare PIN