Individual
BAKUL KUMAR PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1129 N MAIN ST STE G, SOUTH BOSTON, VA 24592-2547
(434) 572-8196
(434) 572-8341
Mailing address
1129 N MAIN ST STE G, SOUTH BOSTON, VA 24592-2547
(345) 728-1964
(434) 572-8341
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
101234858
VA
207RG0100X
Gastroenterology Physician
Primary
2013-00007
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010019087
—
VA
05
—
1912914102
—
NC
05
—
1912914102
—
OH
01
—
465809
ANTHEM
VA
01
—
P00064711
RR M CARE
VA
Enumeration date
08/01/2006
Last updated
10/24/2023
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