Healthcare Provider Details

I. General information

NPI: 1821027251
Provider Name (Legal Business Name): PRASHANT R PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 HIGHLAND AVE STE 130
BETHLEHEM PA
18017-9483
US

IV. Provider business mailing address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

V. Phone/Fax

Practice location:
  • Phone: 610-868-1100
  • Fax: 610-868-1111
Mailing address:
  • Phone: 610-868-1100
  • Fax: 610-868-1111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD423137
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: