Provider Demographics
NPI:1841240835
Name:PATEL, RAJNIKANT T (MD)
Entity type:Individual
Prefix:
First Name:RAJNIKANT
Middle Name:T
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 1:14420 W MEEKER BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-5288
Mailing Address - Country:US
Mailing Address - Phone:623-547-7654
Mailing Address - Fax:623-547-7645
Practice Address - Street 1:14420 W MEEKER BLVD STE 203
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5288
Practice Address - Country:US
Practice Address - Phone:623-547-7654
Practice Address - Fax:623-547-7645
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35169207RC0000X, 207RI0011X
TXK8809207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ146788Medicaid
AZZ213557OtherMEDICARE
AZ35169OtherAZ MEDICAL LICENSE
AZP00359683Medicare PIN