MEDICARE: SONAM PATEL DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	3177	TX
2	213ES0103X	Foot & Ankle Surgery Podiatrist	25MD00380300	NJ

General Provider Information

NPI Number	:	1932763489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONAM PATEL DPM

Provider Business Mailing Address
First Line	:	301 LIPPINCOTT DR STE 410
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-4197
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 ROUTE 73 N LOWR LEVEL
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-4524
Country	:	US
Telephone Number	:	855-548-7634
Fax Number	:	856-355-7127

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

Provider Enumeration Date	:	04/30/2019
Last Update Date	:	04/22/2026

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Directions to “ SONAM PATEL DPM” Practice Location

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