Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 60548 | MN |
N | 208000000X | Pediatrician | 60548 | MN |
NPI | 1003171109 |
---|---|
Provider Name | Nirav Patel |
First Address | Scottsdale, AZ 85255-4134 |
Second Address | Scottsdale, AZ 85255-4134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2012 |
Last Update Date | 04/02/2022 |