Provider Demographics
NPI:1568790921
Name:PATIL, SURESH SHRIPAT (MD)
Entity Type:Individual
Prefix:DR
First Name:SURESH
Middle Name:SHRIPAT
Last Name:PATIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:310 ELECTRIC AVE STE 240
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1369
Practice Address - Country:US
Practice Address - Phone:717-242-8124
Practice Address - Fax:717-242-8125
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2020-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY286749207XS0114X
PAMD466956207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery