Provider Demographics
NPI:1760545578
Name:PATEL, YOGISHCHANDRA A (MD)
Entity Type:Individual
Prefix:DR
First Name:YOGISHCHANDRA
Middle Name:A
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 1:59 TENBY CHASE DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-2440
Mailing Address - Country:US
Mailing Address - Phone:302-239-6193
Mailing Address - Fax:302-633-5582
Practice Address - Street 1:1601 KIRKWOOD HWY
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-4917
Practice Address - Country:US
Practice Address - Phone:302-633-5302
Practice Address - Fax:302-633-5582
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1 - 0000905207RH0003X
PAMD - 422640207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEC1-0000905OtherDE
DE0001106601Medicaid
PAMD-422640OtherPA
DEC48716Medicare UPIN
PAMD-422640OtherPA