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General NPI Number Information
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NPI Number | 1033345160
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Entity Type | Individual
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Provider Name | MUKUL B PATIL MD
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Gender | Male
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Dates
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Enumeration Date | 06/03/2009
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Last Update Date | 12/27/2019
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Provider Practice Location Address
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Address Line | 205 MARY HIGGINSON LN LOWR LEVEL
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City | UNIONTOWN
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State | PA
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Zip | 15401-2658
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Country | US
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Telephone | 724-438-3044
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Fax | 724-438-3911
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Provider Business Mailing Address
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Address Line | 3000 STONEWOOD DR SUITE 200
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City | WEXFORD
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State | PA
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Zip | 15090
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Country | US
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Telephone | 724-934-5520
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Fax | 724-934-5533
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | A107954
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | MD451553
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License Number State | PA
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