MEDICARE: SANDIP G PATEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	41789	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023122249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDIP G PATEL M.D.

Provider Business Mailing Address
First Line	:	26926 N 55TH LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85083-7345
Country	:	US
Telephone Number	:	623-249-5617
Fax Number	:	623-398-6791

Provider Business Practice Location Address
First Line	:	26926 N 55TH LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85083-7345
Country	:	US
Telephone Number	:	623-249-5617
Fax Number	:	623-398-6791

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	11/25/2014

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Directions to “ SANDIP G PATEL M.D.” Practice Location

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