Provider Demographics
NPI:1619104593
Name:PATEL, PUNAL C (MD)
Entity Type:Individual
Prefix:
First Name:PUNAL
Middle Name:C
Last Name:PATEL
Suffix:
Gender:F
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:PO BOX 7540
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-7540
Mailing Address - Country:US
Mailing Address - Phone:480-926-0170
Mailing Address - Fax:480-452-0715
Practice Address - Street 1:3115 S PRICE RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-3544
Practice Address - Country:US
Practice Address - Phone:888-488-7640
Practice Address - Fax:480-452-0715
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR71380207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine