Provider Demographics
NPI:1801897772
Name:PATEL, BANKIMCHANDRA J (MD)
Entity type:Individual
Prefix:DR
First Name:BANKIMCHANDRA
Middle Name:J
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 1:503 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5103
Mailing Address - Country:US
Mailing Address - Phone:256-546-6200
Mailing Address - Fax:256-546-6250
Practice Address - Street 1:503 S 5TH ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5103
Practice Address - Country:US
Practice Address - Phone:256-546-6200
Practice Address - Fax:256-546-6250
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00017905207RC0000X, 207RI0011X
AL17905207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000033737Medicaid
ALF24811Medicare UPIN
AL000033737Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER