Provider Demographics
NPI:1013101567
Name:PATEL, SANDHYABEN P (MD)
Entity type:Individual
Prefix:
First Name:SANDHYABEN
Middle Name:P
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SANDHYA
Other - Middle Name:P
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1900 N HIGLEY RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-1604
Mailing Address - Country:US
Mailing Address - Phone:480-543-2134
Mailing Address - Fax:480-512-6089
Practice Address - Street 1:1900 N HIGLEY RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-1604
Practice Address - Country:US
Practice Address - Phone:480-543-2134
Practice Address - Fax:480-512-6089
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ37474207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ148032OtherMEDICARE PIN MD ANDERSON
AZZ148032OtherMEDICARE PIN MD ANDERSON