Provider Demographics
NPI:1740358639
Name:PATEL, MAHENDRA C (MD)
Entity type:Individual
Prefix:DR
First Name:MAHENDRA
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:111 WEST HIGH STREET
Mailing Address - Street 2:SUITE 305
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-8617
Mailing Address - Country:US
Mailing Address - Phone:410-392-4666
Mailing Address - Fax:410-392-4667
Practice Address - Street 1:111 WEST HIGH STREET
Practice Address - Street 2:SUITE 305
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-8617
Practice Address - Country:US
Practice Address - Phone:410-392-9666
Practice Address - Fax:410-392-4667
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00203732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
D70757Medicare UPIN
MD4452Medicare ID - Type Unspecified