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NPI Code Detail

MEDICARE: GNANESH R PATEL MD

MEDICARE: GNANESH R PATEL MD
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
1207RR0500XRheumatology PhysicianMD449967PA
2207RR0500XRheumatology Physician066301GA

General Provider Information

NPI Number : 1316238298
Entity Type Code : Individual
Provider Name (Legal Business Name) : GNANESH R PATEL MD
Provider Business Mailing Address
First Line : 150 MUNDY ST
Second Line : ARTHRITIS CENTER OF NEPA
City : WILKES BARRE
State : PA
Zip : 18702-6830
Country : US
Telephone Number : 570-824-7117
Fax Number :
Provider Business Practice Location Address
First Line : 150 MUNDY ST
Second Line : ARTHRITIS CENTER OF NEPA
City : WILKES BARRE
State : PA
Zip : 18702-6830
Country : US
Telephone Number : 570-824-7117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2011
Last Update Date : 04/10/2014

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