Provider Demographics
NPI:1366978512
Name:PATEL, JINIT AMRUTBHAI (MD)
Entity type:Individual
Prefix:
First Name:JINIT
Middle Name:AMRUTBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ABBOT MILL LN
Mailing Address - Street 2:APT 9-209
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886
Mailing Address - Country:US
Mailing Address - Phone:732-762-9133
Mailing Address - Fax:
Practice Address - Street 1:326 NICHOLS ROAD
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-1914
Practice Address - Country:US
Practice Address - Phone:978-878-8100
Practice Address - Fax:978-878-8537
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA285749207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110166651AMedicaid