Provider Demographics
NPI:1316238298
Name:PATEL, GNANESH R (MD)
Entity type:Individual
Prefix:
First Name:GNANESH
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:150 MUNDY ST
Mailing Address - Street 2:ARTHRITIS CENTER OF NEPA
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-6830
Mailing Address - Country:US
Mailing Address - Phone:570-824-7117
Mailing Address - Fax:
Practice Address - Street 1:150 MUNDY ST
Practice Address - Street 2:ARTHRITIS CENTER OF NEPA
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-6830
Practice Address - Country:US
Practice Address - Phone:570-824-7117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-26
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD449967207RR0500X
GA066301207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology