Provider Demographics
NPI:1588980650
Name:PATEL, PRAGNA (MD)
Entity type:Individual
Prefix:
First Name:PRAGNA
Middle Name:
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 1:19701 EXECUTIVE PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-2639
Mailing Address - Country:US
Mailing Address - Phone:301-946-6623
Mailing Address - Fax:301-946-1107
Practice Address - Street 1:19701 EXECUTIVE PARK CIR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2639
Practice Address - Country:US
Practice Address - Phone:301-946-6623
Practice Address - Fax:301-946-1107
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-14
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0063399207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine