Healthcare Provider Details

I. General information

NPI: 1306548946
Provider Name (Legal Business Name): PRARTHANA PRAVIN PATKAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 S BAY RD UNIT B
DOVER DE
19901-4615
US

IV. Provider business mailing address

1320 COLLEGE RD
DOVER DE
19904-6508
US

V. Phone/Fax

Practice location:
  • Phone: 302-608-5312
  • Fax:
Mailing address:
  • Phone: 302-213-0809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC1-0028583
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: