Provider Demographics
NPI:1467611574
Name:SEEMA PATEL, MD, PLLC
Entity Type:Organization
Organization Name:SEEMA PATEL, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEEMA
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-439-0274
Mailing Address - Street 1:PO BOX 37984
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85069-7984
Mailing Address - Country:US
Mailing Address - Phone:602-439-0274
Mailing Address - Fax:
Practice Address - Street 1:2423 W DUNLAP AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-2830
Practice Address - Country:US
Practice Address - Phone:602-439-0274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33420282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ907230Medicaid