Provider Demographics
NPI:1700030160
Name:PATEL, DHIREN Y (MD)
Entity Type:Individual
Prefix:DR
First Name:DHIREN
Middle Name:Y
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:941 WHEATLAND AVE
Mailing Address - Street 2:P O BOX 4216
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3180
Mailing Address - Country:US
Mailing Address - Phone:717-394-6028
Mailing Address - Fax:717-394-9223
Practice Address - Street 1:555 N. DUKE STREET
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17604-3555
Practice Address - Country:US
Practice Address - Phone:717-394-6028
Practice Address - Fax:717-394-9223
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2497182085R0202X
PAMD4371162085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023378310001Medicaid
PA23-1855378OtherTAX ID - LANCASTER RADIOLOGY ASSOCIATES
PA33-1011386OtherTAX ID - MRI GROUP
PA23-1855378OtherTAX ID - LANCASTER RADIOLOGY ASSOCIATES