Provider Demographics
NPI:1053304568
Name:PATEL, KANTILAL C (MD)
Entity Type:Individual
Prefix:DR
First Name:KANTILAL
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4217
Practice Address - Street 1:112 NORTH SEVENTH STREET
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201
Practice Address - Country:US
Practice Address - Phone:717-267-3000
Practice Address - Fax:717-217-4217
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028392E207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PA25-1716306OtherFIRST HEALTH
PA25-1716306OtherHEALTHNET/TRICARE
PA2183091OtherMAMSI
PA25-1716306OtherDEVON
PA261422OtherUNISON
PA6906141OtherAETNA HMO
PAMD028392EOtherMEDICAL LICENSE #
PA000920316 0007Medicaid
PA25-1716306OtherINFORMED
PA25-1716306OtherMULTIPLAN/PHCS
PA25-1716306OtherINTERGROUP
PA50082376OtherCAPITAL BLUECROSS
PAPA404696OtherHIGHMARK BLUESHIELD
PA1053304568OtherHEALTH AMERICA
PA050514OtherMEDICARE GROUP #
PA1007307260036OtherMEDICAID GROUP #
PA120420418OtherDEPT OF LABOR
PA5330051OtherAETNA NON-HMO
PAG920-0115/85XWCUOtherCAREFIRST
PAP00683494OtherRAILROAD MEDICARE
PAP00683494OtherRAILROAD MEDICARE
PA25-1716306OtherINFORMED
PA25-1716306OtherMULTIPLAN/PHCS