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General NPI Number Information
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NPI Number | 1184635625
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Entity Type | Individual
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Provider Name | HARSHANA RAJUL PATEL MD
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Gender | Female
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10147W GRAND AVE NORTHWEST EXTENSION CLINIC-VA
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City | SUNCITY
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State | AZ
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Zip | 85351
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Country | US
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Telephone | 602-222-2630
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Fax |
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Provider Business Mailing Address
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Address Line | 1741 E REDFIELD RD
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City | PHOENIX
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State | AZ
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Zip | 85022-4569
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Country | US
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Telephone | 602-548-3273
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 21742
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License Number State | AZ
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