Healthcare Provider Details

I. General information

NPI: 1912101502
Provider Name (Legal Business Name): DHRUVAL HARILAL PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 07/09/2021
Certification Date: 07/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 GILPIN AVE STE 203
WILMINGTON DE
19806-3272
US

IV. Provider business mailing address

1021 GILPIN AVE STE 203
WILMINGTON DE
19806-3272
US

V. Phone/Fax

Practice location:
  • Phone: 27-228-8003
  • Fax: 302-722-8784
Mailing address:
  • Phone: 302-722-8800
  • Fax: 302-722-8784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberC1-0009983
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: