Basic Information
| Provider Information | |||||||||
| NPI: | 1174705164 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | MANISH | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3655 W ANTHEM WAY | ||||||||
| Address2: | SUITE A-109, PMB 313 | ||||||||
| City: | ANTHEM | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850860430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235054479 | ||||||||
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| Practice Location | |||||||||
| Address1: | 19829 N 27TH AVE | ||||||||
| Address2: | ATTN: INDEPENDENT HOSPITALISTS | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850274001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6024063538 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2007 | ||||||||
| LastUpdateDate: | 06/23/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 43463 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 43463 | AZ | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.