Provider Demographics
NPI:1568436673
Name:PATEL, RAKESHKUMAR C (MD)
Entity Type:Individual
Prefix:DR
First Name:RAKESHKUMAR
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2196 E WILLIAMS FIELD RD
Mailing Address - Street 2:#116
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-0754
Mailing Address - Country:US
Mailing Address - Phone:480-237-1395
Mailing Address - Fax:602-218-4076
Practice Address - Street 1:2196 E WILLIAMS FIELD RD
Practice Address - Street 2:#116
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-0754
Practice Address - Country:US
Practice Address - Phone:480-237-1395
Practice Address - Fax:602-218-4076
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ26824207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZH09345Medicare UPIN
AZ60687Medicare ID - Type Unspecified
AZ503400Medicaid