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Organization

ALLEN COUNTY INTERNAL MEDICINE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RUTVIK PATEL MD (OWNER)
(217) 714-0220
Entity
Organization

Contact information

Practice address
12515 GOLDEN HARVEST DR, FORT WAYNE, IN 46845-9031
(217) 714-0220
Mailing address
12515 GOLDEN HARVEST DR, FORT WAYNE, IN 46845-9031
(217) 714-0220

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201240270 A
IN
05
201240270 B
IN
05
201240270 C
IN
05
201240270 D
IN
05
201240270 E
IN
Enumeration date
06/12/2014
Last updated
06/21/2016
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