Provider Demographics
NPI:1457705527
Name:PATEL, BASIL MAULIK (MD)
Entity Type:Individual
Prefix:DR
First Name:BASIL
Middle Name:MAULIK
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 1:209 FLORAL VALE BLVD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5524
Mailing Address - Country:US
Mailing Address - Phone:215-860-6100
Mailing Address - Fax:877-437-7288
Practice Address - Street 1:209 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5524
Practice Address - Country:US
Practice Address - Phone:215-860-6100
Practice Address - Fax:877-437-7288
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME155621207N00000X
390200000X
PAMD482022207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program