Provider Demographics
NPI:1790746774
Name:PATEL, SATISH (MD)
Entity Type:Individual
Prefix:DR
First Name:SATISH
Middle Name:
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:PO BOX 3097
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-0097
Mailing Address - Country:US
Mailing Address - Phone:219-836-8901
Mailing Address - Fax:219-836-8909
Practice Address - Street 1:9108 COLUMBIA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2907
Practice Address - Country:US
Practice Address - Phone:219-836-8901
Practice Address - Fax:219-836-8909
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01042343A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000285227OtherANTHEM INDIANA
IL90001116OtherBLUE CROSS BLUE SHIELD IL
INP01424927OtherMEDICARE RR PTAN
IN110244810OtherMEDICARE RAILROAD
7156639OtherCIGNA
IN100375960Medicaid
ININ2167001OtherMEDICARE PTAN
IL036074197OtherILLINOIS MEDICAID