Healthcare Provider Details

I. General information

NPI: 1518099654
Provider Name (Legal Business Name): NAYAN M PATEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 10/13/2020
Certification Date: 10/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9755 N 90TH ST STE A205
SCOTTSDALE AZ
85258-5079
US

IV. Provider business mailing address

9755 N 90TH ST STE A205
SCOTTSDALE AZ
85258-5079
US

V. Phone/Fax

Practice location:
  • Phone: 480-614-2215
  • Fax: 480-614-2218
Mailing address:
  • Phone: 480-614-2215
  • Fax: 480-614-2218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License Number5030
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number5030
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: