Healthcare Provider Details

I. General information

NPI: 1528377090
Provider Name (Legal Business Name): NACHIKET PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2010
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 N LINDSAY RD STE 103
MESA AZ
85213-7712
US

IV. Provider business mailing address

407 N LINDSAY RD STE 103
MESA AZ
85213-7712
US

V. Phone/Fax

Practice location:
  • Phone: 480-571-1863
  • Fax: 480-571-0269
Mailing address:
  • Phone: 480-571-1863
  • Fax: 480-571-0269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number6397
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number55723
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: