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INDRAJIT J PATEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 867-5201
(228) 867-3152
Mailing address
PO BOX 1810, GULFPORT, MS 39502
(228) 575-1194
(228) 575-2917

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01042231A
IN
207R00000X
Internal Medicine Physician
Primary
23437
MS
208M00000X
Hospitalist Physician
23437
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01622840
BLUE CROSS SHIELD
IL
05
036086539
IL
01
492650
INDIANA MEDICARE
IN
Enumeration date
08/12/2006
Last updated
09/28/2023
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