MEDICARE: DR. MOHAN M PATEL 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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	MD038760L	PA
2	207R00000X	Internal Medicine Physician	MD038760L	PA

General Provider Information

NPI Number	:	1538152863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAN M PATEL MD

Provider Business Mailing Address
First Line	:	224 LONGFELLOW ST
Second Line	:	SUITE 200
City	:	VANDERGRIFT
State	:	PA
Zip	:	15690-1476
Country	:	US
Telephone Number	:	724-568-5551
Fax Number	:	724-568-3137

Provider Business Practice Location Address
First Line	:	224 LONGFELLOW ST
Second Line	:	SUITE 200
City	:	VANDERGRIFT
State	:	PA
Zip	:	15690-1476
Country	:	US
Telephone Number	:	724-568-5551
Fax Number	:	724-568-3137

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	10/12/2020

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