Provider Demographics
NPI:1932302635
Name:PATEL, SUNDIP N (MD)
Entity Type:Individual
Prefix:
First Name:SUNDIP
Middle Name:N
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 1:1 FEDERAL STREET
Mailing Address - Street 2:SUITE SW200
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-356-4935
Mailing Address - Fax:856-356-4879
Practice Address - Street 1:ONE COOPER PLAZA
Practice Address - Street 2:COOPER UNIVERSITY EMERGENCY PHYSICIANS
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103
Practice Address - Country:US
Practice Address - Phone:856-342-2351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA081704207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2802712OtherUNITED HEALTHCARE
NJ0138657Medicaid
NJ60033610OtherHORIZON NJ HEALTH
NJ0589650OtherCIGNA
NJ2862027000OtherAMERIHEALTH/KEYSTONE/IBC
NJ01007832800OtherAMERICHOICE
NJ1597665OtherAETNA
NJP3807806OtherOXFORD
NJ2802712OtherUNITED HEALTHCARE