Provider Demographics
NPI:1811435878
Name:PATEL, PARTH KAMLESH (DO)
Entity type:Individual
Prefix:DR
First Name:PARTH
Middle Name:KAMLESH
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 1:1120 W. MICHIGAN ST.
Mailing Address - Street 2:GATCH HALL CL365
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1701 N SENATE BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1239
Practice Address - Country:US
Practice Address - Phone:317-962-3400
Practice Address - Fax:317-962-3400
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02006346A207P00000X, 207PH0002X, 207LP2900X
WV3535207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN264430C29OtherMEDICARE PTAN
IN300052275Medicaid
INQ00284738OtherRAILROAD PTAN
IN267030308OtherMEDICARE PTAN