Healthcare Provider Details

I. General information

NPI: 1366608879
Provider Name (Legal Business Name): SONAL GIRISH PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2008
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4416 E WEST HWY STE 201
BETHESDA MD
20814-4572
US

IV. Provider business mailing address

4416 E WEST HWY STE 201
BETHESDA MD
20814-4572
US

V. Phone/Fax

Practice location:
  • Phone: 301-652-6800
  • Fax: 301-913-2817
Mailing address:
  • Phone: 301-652-6800
  • Fax: 301-913-2817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036118277
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberA122390
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberD84756
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: