Provider Demographics
NPI:1609154418
Name:PATEL, TARPAN RAJNIKANT (MD)
Entity Type:Individual
Prefix:
First Name:TARPAN
Middle Name:RAJNIKANT
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12361 W BOLA DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85378-9021
Mailing Address - Country:US
Mailing Address - Phone:602-698-7325
Mailing Address - Fax:480-500-8430
Practice Address - Street 1:10825 W MCDOWELL RD STE 310
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-5228
Practice Address - Country:US
Practice Address - Phone:602-698-7325
Practice Address - Fax:480-500-8430
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036133895207RC0000X, 207RI0011X
AZ63204207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease