Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 41789 | AZ |
NPI | 1023122249 |
---|---|
Provider Name | Sandip G Patel |
First Address | Phoenix, AZ 85083-7345 |
Second Address | Phoenix, AZ 85083-7345 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 25/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
430823 | (05) | AZ |