1831149442 NPI number — SAVAN B PATEL MD

Table of content: SAVAN B PATEL MD (NPI 1831149442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831149442 NPI number — SAVAN B PATEL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATEL
Provider First Name:
SAVAN
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831149442
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 SAINT PAUL ST
Provider Second Line Business Mailing Address:
101
Provider Business Mailing Address City Name:
BROOKLINE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02446-6580
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 PARKLAND DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DERRY
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03038-2746
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-421-2143
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  0432027 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: 233720 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: 14718 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100000326281 . This is a "MVP" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 1831149442 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1831149442 . This is a "BMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1831149442 . This is a "TRICARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: AA99715 . This is a "HPHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: J42500 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1831149442 . This is a "ANTHEM BCBS NH" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 2135591 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 510492088 . This is a "UHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00845915 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 1831149442 . This is a "FALLON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30209132 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 95595901 . This is a "NETWORK HEALTH" identifier . This identifiers is of the category "OTHER".




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