Provider Demographics
NPI:1811984255
Name:PATEL, ASHWIN R (MD)
Entity type:Individual
Prefix:DR
First Name:ASHWIN
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2315 W BETHANY HOME RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015
Mailing Address - Country:US
Mailing Address - Phone:602-249-2848
Mailing Address - Fax:602-249-6038
Practice Address - Street 1:2315 W BETHANY HOME RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015
Practice Address - Country:US
Practice Address - Phone:602-249-2848
Practice Address - Fax:602-249-6038
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2016-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ30254207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z6634OtherHEALTH NET
AZ4631274OtherAETNA
AZ5210281003OtherCIGNA
AZ733536Medicaid
AZZ70632OtherMEDICARE PTAN
AZ160762OtherONE HEALTH PLAN
AZ105670OtherPACIFICARE
AZ0714800OtherBCBS
AZ110246968OtherRAILROAD MEDICARE
AZZ70632OtherMEDICARE PTAN
AZ160762OtherONE HEALTH PLAN