Provider Demographics
NPI:1922147321
Name:PATEL, HARSHADBHAI MANIBHAI (MD)
Entity Type:Individual
Prefix:DR
First Name:HARSHADBHAI
Middle Name:MANIBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HARSHAD
Other - Middle Name:M
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4216 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-1360
Mailing Address - Country:US
Mailing Address - Phone:504-466-3702
Mailing Address - Fax:504-468-9374
Practice Address - Street 1:3321 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-3680
Practice Address - Country:US
Practice Address - Phone:504-466-3702
Practice Address - Fax:504-468-9374
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.09704R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1965952Medicaid
LAF17784Medicare UPIN
LA1965952Medicaid