Provider Demographics
NPI:1932339488
Name:DOSTAL, PATRICK JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOSEPH
Last Name:DOSTAL
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:SUITE 467 MOB EAST
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-896-7424
Mailing Address - Fax:610-896-6171
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:SUITE 467 MOB EAST
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-896-7424
Practice Address - Fax:610-896-6171
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2014-09-30
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Provider Licenses
StateLicense IDTaxonomies
PAMD447015207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine