Provider Demographics
NPI:1972794659
Name:PATEL, RISHI KIRIT (MD)
Entity Type:Individual
Prefix:DR
First Name:RISHI
Middle Name:KIRIT
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 1:6036 N 19TH AVE STE 506
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-2143
Mailing Address - Country:US
Mailing Address - Phone:602-245-5525
Mailing Address - Fax:602-224-9119
Practice Address - Street 1:6036 N 19TH AVE STE 506
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-2143
Practice Address - Country:US
Practice Address - Phone:602-246-5525
Practice Address - Fax:602-224-9119
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ56481207RI0011X
CAA104709207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ454164Medicaid