Basic Information
| Provider Information | |||||||||
| NPI: | 1881681237 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | BHARAT KUMAR | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31 ROCHE BROS WAY | ||||||||
| Address2: | |||||||||
| City: | NORTH EASTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023561032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088948730 | ||||||||
| FaxNumber: | 5088948732 | ||||||||
| Practice Location | |||||||||
| Address1: | 31 ROCHE BROS WAY | ||||||||
| Address2: | |||||||||
| City: | NORTH EASTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023561032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088948730 | ||||||||
| FaxNumber: | 5088948732 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2005 | ||||||||
| LastUpdateDate: | 08/07/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 53402 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3115062 | 05 | MA | MEDICAID |