Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MT209468 | PA |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD471595 | PA |
NPI | 1013398486 |
---|---|
Provider Name | Megha P Patel |
First Address | Philadelphia, PA 19104 |
Second Address | Philadelphia, PA 19104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2015 |
Last Update Date | 01/02/2021 |