Basic Information
| Provider Information | |||||||||
| NPI: | 1265532287 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | MILAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3075 RED ARROW DR | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891351625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023881300 | ||||||||
| FaxNumber: | 7022552945 | ||||||||
| Practice Location | |||||||||
| Address1: | 2660 CRIMSON CANYON DR | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891280845 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023881300 | ||||||||
| FaxNumber: | 7022552945 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 12/01/2011 | ||||||||
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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 | 10210 | NV | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 002018708 | 05 | NV | MEDICAID |