Healthcare Provider Details

I. General information

NPI: 1932112026
Provider Name (Legal Business Name): RAJESH PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 S OCTORARA TRAIL
PARKESBURG PA
19365-2100
US

IV. Provider business mailing address

950 S OCTORARA TRAIL
PARKESBURG PA
19365-2100
US

V. Phone/Fax

Practice location:
  • Phone: 610-857-6639
  • Fax: 610-857-6649
Mailing address:
  • Phone: 610-857-6639
  • Fax: 610-857-6649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD429796
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: