Provider Demographics
NPI:1770537151
Name:PATEL, JAGRUTI (MD)
Entity type:Individual
Prefix:DR
First Name:JAGRUTI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:75 HERRICK ST
Mailing Address - Street 2:PARKHURST BUILDING
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-5900
Mailing Address - Country:US
Mailing Address - Phone:978-927-6556
Mailing Address - Fax:
Practice Address - Street 1:75 HERRICK ST
Practice Address - Street 2:PARKHURST BUILDING
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5900
Practice Address - Country:US
Practice Address - Phone:978-927-6556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA202942208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0144231Medicaid
MAH43838Medicare UPIN