MEDICARE: DR. SUBODH G. PATEL 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	208800000X	Urology Physician	MD022718E	PA

General Provider Information

NPI Number	:	1659338598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUBODH G. PATEL M.D.

Provider Business Mailing Address
First Line	:	104 DELAWARE AVE
Second Line	:	SUITE 240
City	:	UNIONTOWN
State	:	PA
Zip	:	15401-3100
Country	:	US
Telephone Number	:	724-438-1300
Fax Number	:	724-438-1400

Provider Business Practice Location Address
First Line	:	104 DELAWARE AVE
Second Line	:	SUITE 240
City	:	UNIONTOWN
State	:	PA
Zip	:	15401-3100
Country	:	US
Telephone Number	:	724-438-1300
Fax Number	:	724-438-1400

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	09/22/2011

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