Individual
JITENDRA I PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
330 N WABASH, STE 450, MARION, IN 46952-2781
(765) 660-7690
Mailing address
330 N WABASH AVE, STE G20, MARION, IN 46952-2600
(765) 660-7600
(765) 651-7313
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
01038195A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000959990
ANTHEM
IN
05
—
100124410
—
IN
Enumeration date
09/07/2006
Last updated
10/19/2020
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