Provider Demographics
NPI:1841636867
Name:PATEL, NAMRATA NIKHIL (MD)
Entity type:Individual
Prefix:DR
First Name:NAMRATA
Middle Name:NIKHIL
Last Name:PATEL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-747-3969
Mailing Address - Fax:314-747-4111
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV IM GENERAL MED, STE 12B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-747-3969
Practice Address - Fax:314-747-4111
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017016658208D00000X, 2080P0204X, 208M00000X, 2080P0204X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200047135Medicaid