Provider Demographics
NPI:1275542508
Name:PATEL, GHANSHYAM (MD)
Entity Type:Individual
Prefix:DR
First Name:GHANSHYAM
Middle Name:
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 1:808 SOUTH 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5210
Mailing Address - Country:US
Mailing Address - Phone:256-543-3047
Mailing Address - Fax:256-543-1770
Practice Address - Street 1:808 SOUTH 4TH ST.
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5210
Practice Address - Country:US
Practice Address - Phone:256-543-3047
Practice Address - Fax:256-543-1770
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00013446207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51019840OtherBCBS OF ALABAMA
AL528902940Medicaid
ALC71750Medicare UPIN
AL51019840OtherBCBS OF ALABAMA