Provider Demographics
NPI:1164658050
Name:PATEL, CHIRDEEP KIRIT (MD)
Entity Type:Individual
Prefix:DR
First Name:CHIRDEEP
Middle Name:KIRIT
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 1:2100 MACK BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5622
Mailing Address - Country:US
Mailing Address - Phone:484-884-0617
Mailing Address - Fax:484-884-0628
Practice Address - Street 1:1250 S CEDAR CREST BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6381
Practice Address - Country:US
Practice Address - Phone:484-884-0617
Practice Address - Fax:484-884-0628
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD447219207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease