Individual
SUKETU PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3010 WILLIAMS DR, SUITE 177, GEORGETOWN, TX 78628-2764
(512) 868-3376
(512) 869-5868
Mailing address
3010 WILLIAMS DR STE 177, GEORGETOWN, TX 78628-2785
(512) 868-3376
(512) 869-5868
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
H0092858
MD
207ZD0900X
Dermatopathology (Pathology) Physician
34.010908
OH
207ZD0900X
Dermatopathology (Pathology) Physician
5101028889
MI
207ZD0900X
Dermatopathology (Pathology) Physician
N7325
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
229989
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0143636
—
OH
Enumeration date
12/18/2006
Last updated
04/13/2026
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