Provider Demographics
NPI:1205823010
Name:PATEL, SURYAKANT J (MD)
Entity Type:Individual
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First Name:SURYAKANT
Middle Name:J
Last Name:PATEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:920 ELKRIDGE LANDING RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2917
Mailing Address - Country:US
Mailing Address - Phone:443-642-5010
Mailing Address - Fax:
Practice Address - Street 1:7501 SURRATTS RD
Practice Address - Street 2:SUITE 303
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3362
Practice Address - Country:US
Practice Address - Phone:301-868-8485
Practice Address - Fax:301-868-0638
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-06
Last Update Date:2016-12-13
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Provider Licenses
StateLicense IDTaxonomies
MDD0019631208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC62118Medicare UPIN