MEDICARE: DR. PRATIK M PATEL MD

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	208800000X	Urology Physician	31431	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	:	1891761169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRATIK M PATEL MD

Provider Business Mailing Address
First Line	:	2730 S VAL VISTA DR
Second Line	:	BLDG.#13, SUITE 177
City	:	GILBERT
State	:	AZ
Zip	:	85295-1675
Country	:	US
Telephone Number	:	480-394-0200
Fax Number	:	480-394-0202

Provider Business Practice Location Address
First Line	:	2730 S VAL VISTA DR
Second Line	:	BLDG 13, SUITE 177
City	:	GILBERT
State	:	AZ
Zip	:	85295-1675
Country	:	US
Telephone Number	:	480-394-0200
Fax Number	:	480-394-0202

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

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	06/18/2020

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