Provider Demographics
NPI:1861889156
Name:DALE, PATRICK (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:DALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 W BALTIMORE PIKE STE 100
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5641
Mailing Address - Country:US
Mailing Address - Phone:610-565-2100
Mailing Address - Fax:610-892-0626
Practice Address - Street 1:53 W BALTIMORE PIKE STE 100
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5641
Practice Address - Country:US
Practice Address - Phone:610-565-2100
Practice Address - Fax:610-892-0626
Is Sole Proprietor?:No
Enumeration Date:2015-04-24
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD480986207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1041618710006Medicaid