Individual
CHETANKUMAR B PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7101 GUILFORD DR, SUITE 201, FREDERICK, MD 21704-5193
(301) 662-2775
(301) 662-2776
Mailing address
7101 GUILFORD DR, SUITE 201, FREDERICK, MD 21704-5193
(301) 662-2775
(301) 662-2776
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
64822
MD
207WX0107X
Retina Specialist (Ophthalmology) Physician
64822
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012122300
—
MD
05
—
0440115
—
IA
01
—
36448
WELLMARK BC/BS
IA
Enumeration date
08/12/2005
Last updated
05/22/2020
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