Individual
RUTVIK S. PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(217) 714-0220
(888) 366-1712
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01062298A
IN
208M00000X
Hospitalist Physician
01062298
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000483128
ANTHEM
IN
01
—
11589279
CAQH
IN
05
—
200825660
—
IN
05
—
2679847
—
OH
Enumeration date
07/10/2006
Last updated
09/29/2023
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