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Individual

MISS DERSHNA PATEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
278 EAGLEVIEW BLVD, EXTON, PA 19341-1157
(512) 888-2088
Mailing address
278 EAGLEVIEW BLVD, EXTON, PA 19341-1157
(512) 888-2088

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
052967
PA
363A00000X
Physician Assistant
Primary
25MP00220100
NJ
363A00000X
Physician Assistant
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
052967
PA
Enumeration date
11/07/2007
Last updated
06/28/2016
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