Individual
KISHAN B PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
909 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1443
(765) 463-6262
(765) 463-9122
Mailing address
PO BOX 781076, DETROIT, MI 48278-1008
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01062245A
IN
207Q00000X
Family Medicine Physician
Primary
01062245A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000485526
ANTHEM PROVIDER PIN / FAMILY PRACTICE-HOSPITALIST
IN
01
—
000000613586
ANTHEM PROVIDER PIN / URGENT CARE
IN
05
—
200828050
—
IN
01
—
9449511
PHCS PID NUMBER
IN
Enumeration date
07/25/2006
Last updated
01/12/2026
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