Provider Demographics
NPI:1821027251
Name:PATEL, PRASHANT R (MD)
Entity Type:Individual
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First Name:PRASHANT
Middle Name:R
Last Name:PATEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:95 HIGHLAND AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-9424
Mailing Address - Country:US
Mailing Address - Phone:610-868-1100
Mailing Address - Fax:610-868-1111
Practice Address - Street 1:3735 NAZARETH RD
Practice Address - Street 2:SUITE 206
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8338
Practice Address - Country:US
Practice Address - Phone:484-503-8281
Practice Address - Fax:484-503-8200
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2014-11-26
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Provider Licenses
StateLicense IDTaxonomies
PAMD4231372085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101258546Medicaid
PA091227Medicare PIN
PA101258546Medicaid