Provider Demographics
NPI:1851928519
Name:EBBERT, PATRICK THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:THOMAS
Last Name:EBBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:330 SOUTH NINTH STREET
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6103
Mailing Address - Country:US
Mailing Address - Phone:215-662-3606
Mailing Address - Fax:215-829-6606
Practice Address - Street 1:330 SOUTH NINTH STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6103
Practice Address - Country:US
Practice Address - Phone:215-662-3606
Practice Address - Fax:215-829-6606
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10191552084N0400X
PAMD4891142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology