Provider Demographics
NPI:1306132139
Name:PATEL, CHETAN NARENDRA (MD)
Entity type:Individual
Prefix:DR
First Name:CHETAN
Middle Name:NARENDRA
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 BENJAMIN FRANKLIN PKWY
Mailing Address - Street 2:N802
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3601
Mailing Address - Country:US
Mailing Address - Phone:917-975-9823
Mailing Address - Fax:
Practice Address - Street 1:2200 BENJAMIN FRANKLIN PKWY
Practice Address - Street 2:N802
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-3601
Practice Address - Country:US
Practice Address - Phone:917-975-9823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2021-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT200189207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine