Provider Demographics
NPI:1295803534
Name:PATEL, MONTU (DO)
Entity type:Individual
Prefix:
First Name:MONTU
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BOXWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-1976
Mailing Address - Country:US
Mailing Address - Phone:978-761-3509
Mailing Address - Fax:
Practice Address - Street 1:1 FORGE VILLAGE RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-2047
Practice Address - Country:US
Practice Address - Phone:978-449-0282
Practice Address - Fax:978-449-0289
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA232230207R00000X, 208M00000X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine