Individual
DR. JAGDISH PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2150 GETTLER ST STE 455, DYER, IN 46311
(219) 864-1100
(219) 864-1118
Mailing address
2150 GETTLER ST STE 455, DYER, IN 46311-2381
(219) 864-1100
(219) 864-1118
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01029938A
IN
207RC0000X
Cardiovascular Disease Physician
036056772
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091333
ANTHEM
IN
01
—
060070689
RR MEDICARE
IL
01
—
06070691
RR MEDICARE
IN
05
—
100322640
—
IN
Enumeration date
06/02/2006
Last updated
07/19/2018
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