MEDICARE: DR. MAHIR 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
1	207N00000X	Dermatology Physician	P1383	TX

General Provider Information

NPI Number	:	1417191917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAHIR PATEL M.D.

Provider Business Mailing Address
First Line	:	7150 GREENVILLE AVE
Second Line	:	STE 100
City	:	DALLAS
State	:	TX
Zip	:	75231-5165
Country	:	US
Telephone Number	:	972-627-4701
Fax Number	:

Provider Business Practice Location Address
First Line	:	347 MOUNT PLEASANT AVE STE 103
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-2745
Country	:	US
Telephone Number	:	973-571-2121
Fax Number	:

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

Provider Enumeration Date	:	04/28/2009
Last Update Date	:	07/21/2022

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