SUDHA R PATNAIK (NPI# 1679509855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679509855 |
| Entity Type | Individual |
| Full Name | SUDHA R PATNAIK |
| Credential | M.D. |
| Practice Address |
5000 Wayne Ave Philadelphia PA 19144-3642 |
| Practice Telephone | 2158489900 |
| Practice Fax Number | 2158484694 |
| Mailing Telephone | 2158489900 |
| Mailing Fax Number | 2158484694 |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | MD038790L | PA | Allopathic & Osteopathic Physicians |
| Street Address |
5000 WAYNE AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19144-3642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649210428 | Ramprasad Patnaik | Family Medicine | 5000 Wayne Ave, Philadelphia, PA 19144-3642 | 2006-06-08 |
| 1912102971 | Ramprasad Patnaik and Sudha Patnaik | Family Medicine | 5000 Wayne Ave, Philadelphia, PA 19144-3676 | 2007-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174053714 | Claudia Palacio | Social Worker | 85 East Logan St., Philadelphia, PA 19144 | 2017-06-15 |
| 1265963391 | Sunil Senior Care LLC | Custodial Care Facility | 220 E Chelten Ave, Philadelphia, PA 19144 | 2017-03-21 |
| 1114460276 | Richard Mitchell | Social Worker | 6327 Burbridge, Philadelphia, PA 19144 | 2016-11-22 |
| 1417399312 | Resources for Human Development | Community/Behavioral Health | 5536 Pulaski Avenue, Philadelphia, PA 19144 | 2013-07-22 |
| 1457601494 | Maikel Griages | Podiatrist | 5555 Wissahickon Avenue, Apt. 216, Philadelphia, PA 19144 | 2012-09-18 |
| 1982977179 | Hota Edward Liu | Dentist | 515 West Chelten Ave, Suite #1, Philadelphia, PA 19144 | 2012-02-17 |
| 1366724585 | Rasidah Campbell | Pharmacist | 5627 Germantown Avenue, Walgreens Pharmacy, Philadelphia, PA 19144 | 2011-09-14 |
| 1326344755 | Lakeva Hamilton-killion | Case Management | 633 W Ritenhouse Street, Apartment B702, Philadelphia, PA 19144 | 2011-02-02 |
| 1083924682 | Merakey Philadelphia | Community/Behavioral Health | 235 - 237 School House Lane, Philadelphia, PA 19144 | 2010-10-15 |
| 1235440785 | Faisal Javed | Internal Medicine | 633 W Rittenhouse Street, Apt B504, Philadelphia, PA 19144 | 2010-06-30 |
| Find all providers in zip 19144 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1366008260 | Ltc Treatment Center Inc | General Practice | 7712 Buist Ave Apt B, Philadelphia, PA 19153-1705 | 2019-05-15 |
| 1972072288 | Paula Alejandra Pino Pommer | General Practice | 3551 North Broad St., Philadelphia, PA 19140-4160 | 2018-11-15 |
| 1689183121 | Gem Wound Specialists, LLC | General Practice | 250 N Columbus Blvd Apt 707, Philadelphia, PA 19106-1458 | 2017-09-27 |
| 1023556875 | Bralow Medical Group | General Practice | 834 South St., Philadelphia, PA 19147 | 2017-02-01 |
| 1790135358 | Jeffrey Anthony Gazzara Jr. | General Practice | 621, 1515 Market Street, Suite 1200, Philadelphia, PA 19102-1921 | 2016-06-14 |
| 1053788240 | J. Todd Willis, Md Clinic | General Practice | 1003 Holland Avenue, Suite 104, Philadelphia, MS 39350-2180 | 2015-08-24 |
| 1225411655 | Brian Michael Lauer | General Practice | 609 E Passyunk Ave Apt 2, Philadelphia, PA 19147-1530 | 2015-07-02 |
| 1003294588 | Health Hero Pa LLC | General Practice | 217 Dickinson St, Philadelphia, PA 19147-6003 | 2015-05-15 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19144 |
Please comment or provide details below to improve the information on SUDHA R PATNAIK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.