Provider Demographics
NPI:1225097637
Name:PATAKI, ANDREW M (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:PATAKI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3454 ELLICOTT CENTER DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-4113
Mailing Address - Country:US
Mailing Address - Phone:410-465-4690
Mailing Address - Fax:410-456-8144
Practice Address - Street 1:3454 ELLICOTT CENTER DR
Practice Address - Street 2:SUITE 103
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-4113
Practice Address - Country:US
Practice Address - Phone:410-465-4690
Practice Address - Fax:410-465-8144
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2008-05-02
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Provider Licenses
StateLicense IDTaxonomies
MDD0030072207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD377BMedicare PIN