Provider Demographics
NPI:1124261656
Name:PATEL, VAISHALI ARUN (MD)
Entity type:Individual
Prefix:
First Name:VAISHALI
Middle Name:ARUN
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5822 RICKY RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:OREFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:18069-8802
Mailing Address - Country:US
Mailing Address - Phone:610-780-5874
Mailing Address - Fax:
Practice Address - Street 1:4505 SAUCON CREEK RD
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-8481
Practice Address - Country:US
Practice Address - Phone:484-526-6545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-01106207R00000X
GA76129207RG0100X
PAMD485690207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD485690OtherPA STATE MEDICAL LICENSE