Provider Demographics
NPI:1174554463
Name:PATEL, MUKESH
Entity type:Individual
Prefix:
First Name:MUKESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 19TH ST S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:619 19TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1900
Practice Address - Country:US
Practice Address - Phone:205-934-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23849207RI0200X
MDD74357207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051527958OtherBCBS
AL051527959OtherBCBS
MD206703000Medicaid
MS00280519Medicaid
AL051527959OtherBLUE CROSS
AL051596130OtherBCBS
P00330853OtherMEDICARE RAILROAD
AL009992235Medicaid
AL051527956OtherBCBS
AL051527957OtherBCBS OF ALABAMA
AL009992245Medicaid
AL009992255Medicaid
AL009992265Medicaid
AL108319Medicaid
P00330853OtherMEDICARE RAILROAD
AL009992255Medicaid