Individual
VIRAJ S PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1904 LAKE AVE, PLYMOUTH, IN 46563-7828
(574) 936-3178
(574) 936-1084
Mailing address
1904 LAKE AVE, PLYMOUTH, IN 46563-7828
(574) 936-3178
(574) 936-1084
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01063921A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000637334
BC BS OF INDIANA
IN
01
—
000000669772
ANTHEM BC BS
IN
05
—
200868150
—
IN
Enumeration date
04/10/2007
Last updated
02/17/2014
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