Provider Demographics
NPI:1780644294
Name:PATEL, CHARU K (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARU
Middle Name:K
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHARULATA
Other - Middle Name:K
Other - Last Name:PARIKH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:245 NICHOLS DRIVE
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-7129
Mailing Address - Country:US
Mailing Address - Phone:508-977-9347
Mailing Address - Fax:508-977-3751
Practice Address - Street 1:60 HODGES AVENUE
Practice Address - Street 2:TAUNTON STATE HOSPITAL
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-0997
Practice Address - Country:US
Practice Address - Phone:508-977-3332
Practice Address - Fax:508-977-3751
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA530282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB54044OtherMEDICARE PART B
MA2066599Medicaid
MAB54044Medicare Oscar/Certification
MA2066599Medicaid