Provider Demographics
NPI:1003847518
Name:PATEL, NATU R (MD)
Entity Type:Individual
Prefix:DR
First Name:NATU
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2792 EGYPT RD
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-2200
Mailing Address - Country:US
Mailing Address - Phone:610-666-9240
Mailing Address - Fax:610-666-1808
Practice Address - Street 1:2792 EGYPT ROAD
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:PA
Practice Address - Zip Code:19403-2255
Practice Address - Country:US
Practice Address - Phone:610-666-9240
Practice Address - Fax:610-666-1808
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 019236 E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
100596Medicare PIN
F06942Medicare UPIN