Provider Demographics
NPI:1598025801
Name:PATEL, PRERANA BHUPENDRAKUMAR (MD)
Entity type:Individual
Prefix:
First Name:PRERANA
Middle Name:BHUPENDRAKUMAR
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-446-4032
Mailing Address - Fax:814-446-4033
Practice Address - Street 1:1 TECH PARK DR STE 1130
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-2517
Practice Address - Country:US
Practice Address - Phone:814-475-8700
Practice Address - Fax:814-475-8798
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT200957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine