Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 14467 | MD |
N | 1223S0112X | Oral and Maxillofacial Surgeon | DS035888 | PA |
N | 208200000X | Surgeon | MT189448 | PA |
N | 208600000X | Surgeon | MT189448 | PA |
NPI | 1073771440 |
---|---|
Provider Name | Dr. Chirag Patel |
First Address | Rockville, MD 20850-8700 |
Second Address | Rockville, MD 20850-8700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2008 |
Last Update Date | 14/07/2009 |