MEDICARE: CHANDRAKANT B. 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	207L00000X	Anesthesiology Physician	16842	AZ

General Provider Information

NPI Number	:	1871590216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANDRAKANT B. PATEL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 12774
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85267-2774
Country	:	US
Telephone Number	:	602-344-5039
Fax Number	:	602-344-0779

Provider Business Practice Location Address
First Line	:	2929 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-8034
Country	:	US
Telephone Number	:	602-344-5039
Fax Number	:	602-344-0779

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	11/14/2011

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