Provider Demographics
NPI:1225053135
Name:BIREN M PATEL
Entity Type:Organization
Organization Name:BIREN M PATEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BIREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-421-2565
Mailing Address - Street 1:PO BOX 12055
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85130-2055
Mailing Address - Country:US
Mailing Address - Phone:520-421-2565
Mailing Address - Fax:520-421-0921
Practice Address - Street 1:1890 E FLORENCE BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-1745
Practice Address - Country:US
Practice Address - Phone:520-421-2565
Practice Address - Fax:520-421-0921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35069208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ109966Medicare PIN