Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 13643 | AZ |
NPI | 1073568952 |
---|---|
Provider Name | Ramesh C. Patri |
First Address | Sun City, AZ 85351-3437 |
Second Address | Sun City, AZ 85351-3437 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 02/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D44453 | (02) | AZ |