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General NPI Number Information
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NPI Number | 1720284441
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Entity Type | Individual
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Provider Name | RUTVIK PATEL D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 06/30/2009
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Provider Practice Location Address
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Address Line | 18404 N TATUM BLVD STE 100
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City | PHOENIX
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State | AZ
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Zip | 85032-1510
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Country | US
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Telephone | 602-992-1900
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Fax | 602-485-7481
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Provider Business Mailing Address
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Address Line | PO BOX 9907
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City | PHOENIX
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State | AZ
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Zip | 85068-0907
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Country | US
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Telephone | 602-992-1900
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Fax | 602-485-7481
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 005100
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License Number State | AZ
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