Individual
DR. ROSHAN S PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 782-2478
Mailing address
377 SPOON DR, POCATELLO, ID 83204-3814
(773) 802-1100
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
M-11088
ID
208D00000X
General Practice Physician
M-11088
ID
Other
Enumeration date
07/25/2008
Last updated
05/01/2018
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