Individual
MR. BHUPENDRA RAMBHAI PATEL SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
512 LACKAWANNA AVENUE, MAYFIELD, PA 18433
(570) 876-0209
Mailing address
512 LACKAWANNA AVENUE, MAYFIELD, PA 18433
(570) 876-0209
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD021212E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
059026610001
—
PA
Enumeration date
04/22/2006
Last updated
07/08/2007
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