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KUNDANBALA PATEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
157 W 8TH ST, FAIRMOUNT, IN 46928-1012
(765) 660-7880
(765) 671-3511
Mailing address
330 NORTH WABASH AVE, SUITE G20, MARION, IN 46952-2600
(765) 660-7600
(765) 651-7313

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01031735A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000108718
ANTHEM BCBS
IN
05
100123620A
IN
Enumeration date
11/14/2005
Last updated
08/21/2012
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