Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD-059559-L | PA |
N | 208600000X | Surgeon | MD-059559-L | PA |
N | 2086S0102X | Surgical Critical Care | MD-059559-L | PA |
Y | 2086S0127X | Trauma Surgeon | MD-059559-L | PA |
NPI | 1407816721 |
---|---|
Provider Name | Dr. Pankaj Harji Patel |
First Address | Philadelphia, PA 19107-5563 |
Second Address | Pennington, NJ 08534-2521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 09/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0001021401 | (05) | DE |
001871486 | (05) | PA |
02316296 | (05) | NY |
1547026 | GATEWAY-WMG (01) | PA |
170856 | UNISON-WMG (01) | PA |
1758618 | HIGHMARK BLUE SHIELD (01) | PA |
20045808 | AMERIHEALTH MERCY-WMG (01) | PA |
2423575000 | AMERIHEALTH 65 PA (01) | PA |
392055 | MAMSI-WMG (01) | PA |
50053498 | CAPITAL BLUE CROSS-WMG (01) | PA |
63568 | GEISINGER (01) | PA |
647030 | CAREFIRST MD BCBS (01) | MD |
683403500 | (05) | MD |
7391171 | AETNA (01) | PA |
8531901 | (05) | NJ |
H18583 | (02) | |
P00251486 | RAILROAD MEDICARE (01) | PA |
Q06003 | (05) | SC |