Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT205562 | PA |
N | 111NI0900X | Internist | MT205562 | PA |
Y | 207RI0011X | Interventional Cardiology | MD474214 | PA |
NPI | 1003234337 |
---|---|
Provider Name | Saurabhkumar Vadilal Patel |
First Address | Danville, PA 17822-4903 |
Second Address | Wilkes Barre, PA 18711-0027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2014 |
Last Update Date | 28/06/2021 |