Healthcare Provider Details

I. General information

NPI: 1538116819
Provider Name (Legal Business Name): KETAN S PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8426 E SHEA BLVD
SCOTTSDALE AZ
85260-6634
US

IV. Provider business mailing address

8426 E SHEA BLVD
SCOTTSDALE AZ
85260-6634
US

V. Phone/Fax

Practice location:
  • Phone: 480-860-4792
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number30681
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: