Provider Demographics
NPI:1396739785
Name:PATEL, DINESHKUMAR H (MD)
Entity type:Individual
Prefix:
First Name:DINESHKUMAR
Middle Name:H
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 1:3811 E BELL RD
Mailing Address - Street 2:STE 200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2138
Mailing Address - Country:US
Mailing Address - Phone:602-787-1830
Mailing Address - Fax:602-787-1835
Practice Address - Street 1:3811 E BELL RD
Practice Address - Street 2:STE 200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2138
Practice Address - Country:US
Practice Address - Phone:602-787-1830
Practice Address - Fax:602-787-1835
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21960207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ191271Medicaid
AZAZ0825160OtherBLUE CROSS BLUE SHIELD
AZ223819Medicare ID - Type Unspecified
AZ191271Medicaid