Provider Demographics
NPI:1205805553
Name:PATEL, BIREN G (MD)
Entity type:Individual
Prefix:DR
First Name:BIREN
Middle Name:G
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 1:14674 W MOUNTAIN VIEW BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-2706
Mailing Address - Country:US
Mailing Address - Phone:623-546-1400
Mailing Address - Fax:623-546-0745
Practice Address - Street 1:14674 W MOUNTAIN VIEW BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-2706
Practice Address - Country:US
Practice Address - Phone:623-546-1400
Practice Address - Fax:623-546-0745
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ26753208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ119732Medicare PIN
G71875Medicare UPIN