Provider Demographics
NPI:1689811176
Name:PATEL, ASHISHKUMAR KANU (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHISHKUMAR
Middle Name:KANU
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:901 E WILLETTA ST
Mailing Address - Street 2:ROOM 2503
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2727
Mailing Address - Country:US
Mailing Address - Phone:602-546-0676
Mailing Address - Fax:
Practice Address - Street 1:4722 N 24TH ST
Practice Address - Street 2:SUITE 150
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4800
Practice Address - Country:US
Practice Address - Phone:602-256-4628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ415532080N0001X
TXN46512080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine