Basic Information
Provider Information
NPI: 1801858113
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: SUMIR
MiddleName: M.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3020 E CAMELBACK RD STE 301
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850164418
CountryCode: US
TelephoneNumber: 6022649100
FaxNumber: 6022619101
Practice Location
Address1: 603 W BASELINE RD STE 200
Address2:  
City: MESA
State: AZ
PostalCode: 852106047
CountryCode: US
TelephoneNumber: 4804611088
FaxNumber: 4804611657
Other Information
ProviderEnumerationDate: 04/03/2006
LastUpdateDate: 10/14/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X32270AZY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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