Individual
DR. JAY B PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
610 N MICHIGAN ST STE 306, SOUTH BEND, IN 46601-1079
(574) 647-6500
(574) 647-6518
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01065995A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201301490
—
IN
Enumeration date
05/21/2008
Last updated
12/06/2017
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