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NPI Code Detail

MEDICARE: SAMIR B PATEL M.D.

MEDICARE:   SAMIR B PATEL  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
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine Physician25MA09103600NJ

General Provider Information

NPI Number : 1396075958
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMIR B PATEL M.D.
Provider Business Mailing Address
First Line : 11 ELLERDALE RD
Second Line :
City : FALLSINGTON
State : PA
Zip : 19054-1139
Country : US
Telephone Number : 267-249-7703
Fax Number : 215-295-4182
Provider Business Practice Location Address
First Line : 11 ELLERDALE RD
Second Line :
City : FALLSINGTON
State : PA
Zip : 19054-1139
Country : US
Telephone Number : 267-249-7703
Fax Number : 215-295-4182
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2010
Last Update Date : 11/27/2019

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Directions to “ SAMIR B PATEL M.D.” Practice Location

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