Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 37468 | AZ |
NPI | 1215121512 |
---|---|
Provider Name | Dr. Parag Rasik Patel |
First Address | Sierra Vista, AZ 85636-2186 |
Second Address | Sierra Vista, AZ 85635-6354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2007 |
Last Update Date | 04/09/2021 |