Provider Demographics
NPI:1265472757
Name:PATEL, HARSHAD S (MD)
Entity Type:Individual
Prefix:DR
First Name:HARSHAD
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5700 W OLIVE AVE
Mailing Address - Street 2:108
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-3147
Mailing Address - Country:US
Mailing Address - Phone:623-842-3077
Mailing Address - Fax:623-934-8773
Practice Address - Street 1:5700 W OLIVE AVE
Practice Address - Street 2:108
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-3147
Practice Address - Country:US
Practice Address - Phone:623-842-3077
Practice Address - Fax:623-934-8773
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2019-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ22757207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ187931Medicaid
AZF23745Medicare UPIN
AZZ61643Medicare PIN