Provider Demographics
NPI:1508807330
Name:PATEL, NILESH V (MD)
Entity Type:Individual
Prefix:
First Name:NILESH
Middle Name:V
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 1:2793 EGYPT RD
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-2254
Mailing Address - Country:US
Mailing Address - Phone:610-666-1400
Mailing Address - Fax:610-666-1445
Practice Address - Street 1:2793 EGYPT RD
Practice Address - Street 2:SUITE 409
Practice Address - City:AUDUBON
Practice Address - State:PA
Practice Address - Zip Code:19403-2254
Practice Address - Country:US
Practice Address - Phone:610-666-1400
Practice Address - Fax:610-666-1445
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD048674L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018381130003Medicaid
PA0688793000OtherAMERIHEALTH/INTERCOUNTY
PA17713-MD048674LOtherHEALTH PARTNERS
PAP812705OtherOXFORD
PA0688793000OtherIBC - PC/KHPE
PA1186255OtherCIGNA HMO/PPO
PA1086908OtherKEYSTONE MERCY
PA10933864OtherCAQH ID#
PA080134535OtherRRM
PA2244543OtherAETNA PPO
PA350802OtherPHCS
PAX000488501OtherAMERICHOICE (UHC MA PLAN)
PA520080OtherHIGHMARK BLUE SHIELD
PA350802OtherPHCS
PAP812705OtherOXFORD