Provider Demographics
NPI:1356365100
Name:PATEL, SAMIR (MD)
Entity type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:163 LIBBEY INDUSTRIAL PKWY
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-3137
Mailing Address - Country:US
Mailing Address - Phone:781-337-4224
Mailing Address - Fax:781-335-0429
Practice Address - Street 1:163 LIBBEY INDUSTRIAL PKWY
Practice Address - Street 2:SUITE 301
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3137
Practice Address - Country:US
Practice Address - Phone:781-337-4224
Practice Address - Fax:781-335-0429
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2020-04-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA157094207L00000X, 207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA42738OtherHEALTHY START
MAP00180972OtherPALMETTO GBA
MA277311OtherHARVARD PILGRIM
MAG53914OtherTRICARE
MA157094OtherTUFTS HEALTH PLAN
MA3187578Medicaid
MA39955OtherFALLON
MAJ19030OtherBLUE SHIELD
MAG53914OtherTRICARE
MA3187578Medicaid
MAG53914Medicare UPIN
MAP00180972OtherPALMETTO GBA