| Bharat K Patel Sc | |
|
12 Hospital Dr. Memorial Heights Metropolis IL 62960 | |
| (618) 524-2182 | |
| (618) 524-2451 |
| Full Name | Bharat K Patel Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12 Hospital Dr., Metropolis, Illinois |
| Authorized Official Name and Position | Bharat K Patel (PRESIDENT) |
| Authorized Official Contact | 6185242182 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bharat K Patel Sc Po Box 191 Memorial Heights Metropolis IL 62960 Ph: (618) 524-2182 | Bharat K Patel Sc 12 Hospital Dr. Memorial Heights Metropolis IL 62960 Ph: (618) 524-2182 |
| NPI Number | 1083736680 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 07/22/2010 |
| Medicare PECOS PAC ID | 5597701441 |
|---|---|
| Medicare Enrollment ID | O20050630001095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083736680 | NPI | - | NPPES |
| 0006400031 | Other | IL | BCBS |
| 036055925 | Medicaid | IL | |
| K19391 | Other | IL | GROUP MEDICARE |
| 1083736680 | Other | IL | GROUP NPI |
| 1992735526 | Medicaid | IL | |
| 036113119 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036055925 (Illinois) | Primary |
| Provider Name | Bharat K Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992735526 PECOS PAC ID: 0547151417 Enrollment ID: I20080424000026 |
| Provider Name | Mallory R Wittig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114285517 PECOS PAC ID: 3870743883 Enrollment ID: I20121029000755 |
| Provider Name | Alyce Hannan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073153235 PECOS PAC ID: 4587092283 Enrollment ID: I20200311001963 |
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