Healthcare Provider Details

I. General information

NPI: 1184706384
Provider Name (Legal Business Name): MEENAL V PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4410 W UNION HILLS DR # 7-280
GLENDALE AZ
85308-1660
US

IV. Provider business mailing address

4410 W UNION HILLS DR # 7-280
GLENDALE AZ
85308-1660
US

V. Phone/Fax

Practice location:
  • Phone: 623-974-6611
  • Fax:
Mailing address:
  • Phone: 623-974-6611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number32504
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMC-230
License Number StateGU

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: