Provider Demographics
NPI:1780105783
Name:PATEL, PRADEEP (MD)
Entity type:Individual
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First Name:PRADEEP
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:1613 ROUTE 38 FL 1
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-2921
Practice Address - Country:US
Practice Address - Phone:609-444-5566
Practice Address - Fax:609-261-5507
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2021-01-22
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA10967200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine