| Doctor Name: | SAMIR B PATEL |
| NPI Number: | 1003801291 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 01046230 |
| Business Practice Address: | 620 W Edison Rd Suite 110 Mishawaka, IN - 465452784 |
| Business Phone Number: | 5742581100 |
| Business Fax Number: | 5742581101 |
| Mailing Address: | 620 W Edison Rd, Suite 110 MISHAWAKA |
| State: | IN |
| Postal Code: | 465452784 |
| Phone Number: | 5742581100 |
| Fax Number: | 5742581101 |
| NPI Enumeration Date: | 09/14/2005 |
| NPI Last Update Date: | 05/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | 01046230 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |