Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 036118277 | IL |
N | 2084N0402X | Child Neurologist | A122390 | CA |
Y | 2084N0402X | Child Neurologist | D84756 | MD |
NPI | 1366608879 |
---|---|
Provider Name | Dr. Sonal Girish Patel |
First Address | Bethesda, MD 20814-4572 |
Second Address | Bethesda, MD 20814-4572 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2008 |
Last Update Date | 09/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0222075 | BLUE CROSS GROUP NUMBER (01) | IL |
036118277 | (05) | IL |
1033149844 | GROUP NPI (01) | IL |
1366608879 | NPI (01) | IL |
363149833 | GROUP TAX IDENTIFICATION NUMBER (01) | IL |
3631498336019001 | CDPG HFS PAYEE ID (01) | IL |