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General NPI Number Information
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NPI Number | 1760611032
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Entity Type | Individual
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Provider Name | SAMIR PATEL DPM
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Gender | Male
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 01/17/2017
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Provider Practice Location Address
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Address Line | 1546 PRATT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19124-1923
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Country | US
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Telephone | 215-533-8555
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Fax | 215-533-8656
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Provider Business Mailing Address
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Address Line | 1546 PRATT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19124-1923
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Country | US
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Telephone | 908-705-1757
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Fax | 215-787-9398
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC006131
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License Number State | PA
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