Provider Demographics
NPI:1811492697
Name:PATEL, KUNAL G (MD)
Entity type:Individual
Prefix:
First Name:KUNAL
Middle Name:G
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:125 WHIPPLE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-3258
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 BOSTON MEDICAL CTR PL
Practice Address - Street 2:BCD 1ST FL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2908
Practice Address - Country:US
Practice Address - Phone:617-414-5481
Practice Address - Fax:617-414-7759
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2024-09-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA291654207P00000X
RIMD20213207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110135985AMedicaid