=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023638459
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AKULKUMAR MUKESHBHAI PATEL MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/27/2020
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9896 BUSTLETON AVE
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19115-5202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-279-5960
-----------------------------------------------------
Fax | 877-384-3106
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9896 BUSTLETON AVE
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19115-5202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-279-5960
-----------------------------------------------------
Fax | 877-384-3106
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 1022952
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD481414
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------