Provider Demographics
NPI:1972612786
Name:PATEL, HARISCHANDRA S (MD)
Entity Type:Individual
Prefix:
First Name:HARISCHANDRA
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-4214
Mailing Address - Country:US
Mailing Address - Phone:812-242-3120
Mailing Address - Fax:812-242-3846
Practice Address - Street 1:221 S 6TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47807-4214
Practice Address - Country:US
Practice Address - Phone:812-242-3120
Practice Address - Fax:812-242-3846
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01043234A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000089590OtherANTHEM
IN200009970AMedicaid
0182850OtherUS DEPT OF LABOR
048060OtherCIGNA
259228OtherHARMONY HEALTH PLAN IND
276725OtherHEALTHLINK
I018482D059OtherUNISYS CHAMPUS SECONDARY
5121212OtherAETNA
INP00844251OtherRAILROAD MEDICARE
080061863OtherRAILROAD MCARE PALAMETTO
351904269112OtherCARESOURCE MEDICAID
048060OtherCIGNA
080061863OtherRAILROAD MCARE PALAMETTO
IN859910PPMedicare PIN
276725OtherHEALTHLINK