Provider Demographics
NPI:1043405301
Name:PATEL, ANKUR ASHOK (DO, M H A)
Entity Type:Individual
Prefix:DR
First Name:ANKUR
Middle Name:ASHOK
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO, M H A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2149 E WARNER RD #102
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-3495
Mailing Address - Country:US
Mailing Address - Phone:480-610-6100
Mailing Address - Fax:
Practice Address - Street 1:9305 W THOMAS RD STE 255
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3364
Practice Address - Country:US
Practice Address - Phone:480-610-6100
Practice Address - Fax:623-846-0438
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4644207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ291846Medicaid
Z137931Medicare PIN