Provider Demographics
NPI:1518099654
Name:PATEL, NAYAN M (DO)
Entity Type:Individual
Prefix:
First Name:NAYAN
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9755 N 90TH ST STE A205
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5079
Mailing Address - Country:US
Mailing Address - Phone:480-614-2215
Mailing Address - Fax:480-614-2218
Practice Address - Street 1:9755 N 90TH ST STE A205
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5079
Practice Address - Country:US
Practice Address - Phone:480-614-2215
Practice Address - Fax:480-614-2218
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5030207RT0003X, 207RG0100X
NC2012-00120207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant Hepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z122530Medicare PIN