Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 30681 | AZ |
NPI | 1538116819 |
---|---|
Provider Name | Ketan S Patel |
First Address | Scottsdale, AZ 85255-7819 |
Second Address | Scottsdale, AZ 85255-7819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BP4716950 | DEA (01) | AZ |