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General NPI Number Information
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NPI Number | 1982722294
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Entity Type | Organization
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Legal Business Name | SUBODH G. PATEL M.D.P.C.
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 09/22/2011
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Provider Practice Location Address
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Address Line | 104 DELAWARE AVE SUITE 240
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City | UNIONTOWN
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State | PA
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Zip | 15401-3100
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Country | US
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Telephone | 724-438-1300
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Fax | 724-438-1400
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Provider Business Mailing Address
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Address Line | 306 SARATOGA DR
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City | UNIONTOWN
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State | PA
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Zip | 15401-5600
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Country | US
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Telephone | 724-439-8072
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Fax | 724-438-1400
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUBODH G. PATEL
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Credential | M.D.
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Telephone | 724-438-1300
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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 | MD022718E
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License Number State | PA
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