MEDICARE: MARY LOU PATTON MD

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	208600000X	Surgery Physician	MD031133E	PA

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	:	1144290875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY LOU PATTON MD

Provider Business Mailing Address
First Line	:	ONE MEDICAL CENTER BLVD
Second Line	:	SUITE 241
City	:	CHESTER
State	:	PA
Zip	:	19013-3902
Country	:	US
Telephone Number	:	610-619-7400
Fax Number	:	610-872-4015

Provider Business Practice Location Address
First Line	:	ONE MEDICAL CENTER BLVD
Second Line	:	SUITE 241
City	:	CHESTER
State	:	PA
Zip	:	19013-3902
Country	:	US
Telephone Number	:	610-619-7400
Fax Number	:	610-872-4015

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	07/08/2007

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