Provider Demographics
NPI:1821054503
Name:PATEL, VINOD B (MD)
Entity Type:Individual
Prefix:DR
First Name:VINOD
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:VINOD
Other - Middle Name:B
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9874 E DREYFUS AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-4466
Mailing Address - Country:US
Mailing Address - Phone:480-860-0157
Mailing Address - Fax:623-915-2099
Practice Address - Street 1:5620 W THUNDERBIRD RD STE B3
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4638
Practice Address - Country:US
Practice Address - Phone:480-860-0157
Practice Address - Fax:623-915-2099
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ149712084B0002X, 2084P0804X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084B0002XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyObesity Medicine
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ14971OtherBOARD OF MEDICAL EXAMINER
AZAP2680026OtherDEA
AZ14971OtherBOARD OF MEDICAL EXAMINER