Provider Demographics
NPI:1356350664
Name:PATEL, ANIL S (MD)
Entity type:Individual
Prefix:DR
First Name:ANIL
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3340 EAST GOLDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1026
Mailing Address - Country:US
Mailing Address - Phone:208-367-5171
Mailing Address - Fax:208-367-5180
Practice Address - Street 1:1075 N. CURTIS ROAD
Practice Address - Street 2:STE 200
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-1350
Practice Address - Country:US
Practice Address - Phone:208-367-8333
Practice Address - Fax:208-367-2003
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN47254208M00000X, 207RC0200X
IDM-11375207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN132703OtherUCARE MN
MN2275790OtherAMERICA'S PPO
MN390L4PAOtherBCBS OF MN
MN7012713OtherAETNA
MN914642300Medicaid
MN0407183OtherMEDICA
MN1042626OtherPREFERRED ONE
MNHP48160OtherHEALTHPARTNERS
MNI23229Medicare UPIN
MN390L4PAOtherBCBS OF MN
MN914642300Medicaid
MN1042626OtherPREFERRED ONE
MN110013966Medicare PIN