Healthcare Provider Details

I. General information

NPI: 1174573240
Provider Name (Legal Business Name): ANAR J PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 06/30/2025
Certification Date: 06/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 W D. L. INGRAM AVENUE BLDG. 1408
CANNON AFB NM
88103
US

IV. Provider business mailing address

224 W D. L. INGRAM AVENUE BLDG. 1408
CANNON AFB NM
88103
US

V. Phone/Fax

Practice location:
  • Phone: 575-904-3917
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0084717
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberME150162
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: