Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204E00000X | Oral & Maxillofacial Surgeon | MD031132E | PA |
N | 208200000X | Surgeon | MD031132E | PA |
N | 208600000X | Surgeon | MD031132E | PA |
N | 2082S0105X | Plastic Hand Surgeon | MD031132E | PA |
N | 208200000X | Surgeon | MD031132E | PA |
N | 208600000X | Surgeon | MD031132E | PA |
N | 2086S0105X | Surgery of the Hand | MD031132E | PA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD031132E | PA |
NPI | 1104984400 |
---|---|
Provider Name | Dr. Jaykumar C Patel |
First Address | Newtown, PA 18940-1171 |
Second Address | Bristol, PA 19007-3101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 30/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000080208 | HIGHMARK BLUE SHIELD (01) | PA |
00524710000 | INDEPEDENCE BLUE CROSS (01) | PA |
07341843 | (05) | PA |
240001232 | RAILROAD MEDICARE (01) | PA |
AP2183109 | DEA NUMBER (01) | PA |
C29232 | (02) | PA |