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Individual

MAYUR ASHOK PATEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5215 HOLY CROSS PKWY, MISHAWAKA, IN 46545-1469
(574) 233-3123
(574) 233-3125
Mailing address
PO BOX 1742, SOUTH BEND, IN 46634-1742
(574) 233-3123
(574) 233-3125

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01073954A
IN
207L00000X
Anesthesiology Physician
125-056166
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201228330
IN
Enumeration date
06/23/2010
Last updated
12/10/2014
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