Individual
RINA A PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1310 S LEBANON ST, LEBANON, IN 46052-2792
(765) 482-7005
(765) 483-2517
Mailing address
1310 S LEBANON ST, LEBANON, IN 46052-2792
(765) 482-7005
(765) 483-2517
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01072716A
IN
207Q00000X
Family Medicine Physician
25MA07534400
NJ
207Q00000X
Family Medicine Physician
50765
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0041939
—
NJ
05
—
300056527
—
IN
05
—
34931400
—
WI
01
—
WI1755
MEDICARE GROUP PTAN
WI
01
—
WI1755003
MEDICARE INDIVIDUAL PTAN
WI
Enumeration date
11/20/2006
Last updated
11/30/2021
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