Individual
JITENDRA C PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
97825 SHOPPING CENTER AVE, BROOKINGS, OR 97415
(541) 412-9800
(541) 412-9600
Mailing address
PO BOX 2742, HARBOR, OR 97415-0326
(541) 412-9800
(541) 412-9600
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD15202
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151183
—
OR
Enumeration date
06/10/2005
Last updated
11/08/2007
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