Healthcare Provider Details

I. General information

NPI: 1932302635
Provider Name (Legal Business Name): SUNDIP N PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE COOPER PLAZA COOPER UNIVERSITY EMERGENCY PHYSICIANS
CAMDEN NJ
08103
US

IV. Provider business mailing address

1 FEDERAL STREET SUITE SW200
CAMDEN NJ
08103-1155
US

V. Phone/Fax

Practice location:
  • Phone: 856-342-2351
  • Fax:
Mailing address:
  • Phone: 856-356-4935
  • Fax: 856-356-4879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMA081704
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: