Basic Information
Provider Information
NPI: 1174781975
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: SACHIN
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10540 MARTY ST
Address2: SUITE 100
City: OVERLAND PARK
State: KS
PostalCode: 662122551
CountryCode: US
TelephoneNumber: 9136601616
FaxNumber: 9136601664
Practice Location
Address1: 20333 W 151ST ST
Address2:  
City: OLATHE
State: KS
PostalCode: 660615350
CountryCode: US
TelephoneNumber: 9137914200
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/28/2008
LastUpdateDate: 01/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X2008020594MON Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X04-33279KSY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home