Basic Information
| Provider Information | |||||||||
| NPI: | 1952680332 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | GAURAV | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1098 W BALTIMORE PIKE STE 3402 | ||||||||
| Address2: | |||||||||
| City: | MEDIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190635139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105653250 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1098 W BALTIMORE PIKE STE 3402 | ||||||||
| Address2: | |||||||||
| City: | MEDIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105653250 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2011 | ||||||||
| LastUpdateDate: | 10/08/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | P5119 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RC0200X | MD458639 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RS0012X | MD458639 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 207RP1001X | P5119 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RP1001X | MD458639 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.