MEDICARE: DR. JONATHAN L PATTERSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	D0065095	MD
2	2085U0001X	Diagnostic Ultrasound Physician	C10004811	DE
3	2085B0100X	Body Imaging Physician	C10004811	DE
4	2085D0003X	Diagnostic Neuroimaging (Radiology) Physician	C10004811	DE
5	2085P0229X	Pediatric Radiology Physician	C10004811	DE
6	2085R0202X	Diagnostic Radiology Physician	C10004811	DE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053391953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN L PATTERSON M.D.

Provider Business Mailing Address
First Line	:	611 FEDERAL ST STE 4
Second Line	:
City	:	MILTON
State	:	DE
Zip	:	19968-1157
Country	:	US
Telephone Number	:	302-684-5151
Fax Number	:	302-684-1977

Provider Business Practice Location Address
First Line	:	611 FEDERAL ST STE 4
Second Line	:
City	:	MILTON
State	:	DE
Zip	:	19968-1157
Country	:	US
Telephone Number	:	302-684-5151
Fax Number	:	302-684-1977

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	08/29/2024

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Directions to “ DR. JONATHAN L PATTERSON M.D.” Practice Location

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