Provider Demographics
NPI:1184635625
Name:PATEL, HARSHANA RAJUL (MD)
Entity Type:Individual
Prefix:
First Name:HARSHANA
Middle Name:RAJUL
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1741 E REDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-4569
Mailing Address - Country:US
Mailing Address - Phone:602-548-3273
Mailing Address - Fax:
Practice Address - Street 1:10147W GRAND AVE
Practice Address - Street 2:NORTHWEST EXTENSION CLINIC-VA
Practice Address - City:SUNCITY
Practice Address - State:AZ
Practice Address - Zip Code:85351
Practice Address - Country:US
Practice Address - Phone:602-222-2630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21742207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine