Provider Demographics
NPI:1780642975
Name:PATEL, MRUGESH B (MD)
Entity Type:Individual
Prefix:
First Name:MRUGESH
Middle Name:B
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 1:240 MIDDLETOWN BLVD STE 101C
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1832
Mailing Address - Country:US
Mailing Address - Phone:267-560-5461
Mailing Address - Fax:267-358-5448
Practice Address - Street 1:240 MIDDLETOWN BLVD
Practice Address - Street 2:STE 101C
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1832
Practice Address - Country:US
Practice Address - Phone:267-560-5461
Practice Address - Fax:267-358-5448
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07133500207RC0000X
PAMD068305L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000720024OtherHIGHMARK BCBS
PA0017666500004Medicaid
PA656195OtherMEDICARE
NJ8570001Medicaid
NJ8570001Medicaid