Provider Demographics
NPI:1053374256
Name:PATEL, PANKAJ J (MD)
Entity type:Individual
Prefix:DR
First Name:PANKAJ
Middle Name:J
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3581 S HIGHLANDS AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-5410
Mailing Address - Country:US
Mailing Address - Phone:863-385-5129
Mailing Address - Fax:863-385-7162
Practice Address - Street 1:3581 S HIGHLANDS AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-5410
Practice Address - Country:US
Practice Address - Phone:863-385-5129
Practice Address - Fax:863-385-7162
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2013-02-28
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Provider Licenses
StateLicense IDTaxonomies
FLME87907207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H25983Medicare UPIN