Provider Demographics
NPI:1952383721
Name:PATEL, RAJ S (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJ
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:750 N ESTRELLA PKWY
Mailing Address - Street 2:SUITE 20
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-9272
Mailing Address - Country:US
Mailing Address - Phone:623-298-4642
Mailing Address - Fax:623-925-9193
Practice Address - Street 1:750 N ESTRELLA PKWY
Practice Address - Street 2:SUITE 20
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-9272
Practice Address - Country:US
Practice Address - Phone:623-298-4642
Practice Address - Fax:623-925-9193
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2010-06-07
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Provider Licenses
StateLicense IDTaxonomies
AZ34296208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ957615Medicaid