Healthcare Provider Details

I. General information

NPI: 1316352248
Provider Name (Legal Business Name): PRITI R PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S ALMA SCHOOL RD STE 16350
MESA AZ
85210-1191
US

IV. Provider business mailing address

1201 S ALMA SCHOOL RD STE 16350
MESA AZ
85210-1191
US

V. Phone/Fax

Practice location:
  • Phone: 623-267-6601
  • Fax:
Mailing address:
  • Phone: 602-267-6601
  • Fax: 480-900-8279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR-3585
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number50349
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number58079
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: