MEDICARE: DR. SANJAY PATTANI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	M7510	TX
2	207P00000X	Emergency Medicine Physician	D0067779	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295785053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANJAY PATTANI M.D.

Provider Business Mailing Address
First Line	:	4324 DONCASTER DR
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-6782
Country	:	US
Telephone Number	:	410-696-2415
Fax Number	:

Provider Business Practice Location Address
First Line	:	9229 LBJ FWY
Second Line	:	PSR, INC
City	:	DALLAS
State	:	TX
Zip	:	75243-3405
Country	:	US
Telephone Number	:	214-860-6038
Fax Number	:	972-852-9082

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	04/07/2010

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Directions to “ DR. SANJAY PATTANI M.D.” Practice Location

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