Provider Demographics
NPI:1336885300
Name:PATEL, SAKSHAR TEJASBHAI (MD)
Entity Type:Individual
Prefix:
First Name:SAKSHAR
Middle Name:TEJASBHAI
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 1:4170 CITY AVENUE, PHILADELPHIA COLLEGE OF OSTEOPATHIC M
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4170 CITY AVENUE, PHILADELPHIA COLLEGE OF OSTEOPATHIC M
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131
Practice Address - Country:US
Practice Address - Phone:215-871-6646
Practice Address - Fax:215-871-6695
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program