Provider Demographics
NPI:1427049824
Name:PATEL, MAULIKKUMAR B (MD)
Entity type:Individual
Prefix:
First Name:MAULIKKUMAR
Middle Name:B
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 1:540 N DUKE ST
Mailing Address - Street 2:SUITE 244
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2374
Mailing Address - Country:US
Mailing Address - Phone:717-544-4930
Mailing Address - Fax:717-544-4964
Practice Address - Street 1:540 N DUKE ST
Practice Address - Street 2:SUITE 244
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2374
Practice Address - Country:US
Practice Address - Phone:717-544-4930
Practice Address - Fax:717-544-4964
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238131207R00000X
PAMD430235207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010198747Medicaid
PA1023303670001Medicaid
VA010198747Medicaid