Basic Information
| Provider Information | |||||||||
| NPI: | 1356350664 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | ANIL | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3340 EAST GOLDSTONE WAY | ||||||||
| Address2: | |||||||||
| City: | MERIDIAN | ||||||||
| State: | ID | ||||||||
| PostalCode: | 836421026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2083675171 | ||||||||
| FaxNumber: | 2083675180 | ||||||||
| Practice Location | |||||||||
| Address1: | 1075 N. CURTIS ROAD | ||||||||
| Address2: | STE 200 | ||||||||
| City: | BOISE | ||||||||
| State: | ID | ||||||||
| PostalCode: | 837061350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2083678333 | ||||||||
| FaxNumber: | 2083672003 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 08/23/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 47254 | MN | N | Allopathic & Osteopathic Physicians | Hospitalist | 207RC0200X | 47254 | MN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RC0200X | M-11375 | ID | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 132703 | 01 | MN | UCARE MN | OTHER | 2275790 | 01 | MN | AMERICA'S PPO | OTHER | 390L4PA | 01 | MN | BCBS OF MN | OTHER | 7012713 | 01 | MN | AETNA | OTHER | 914642300 | 05 | MN | MEDICAID | 0407183 | 01 | MN | MEDICA | OTHER | 1042626 | 01 | MN | PREFERRED ONE | OTHER | HP48160 | 01 | MN | HEALTHPARTNERS | OTHER |