Harshana Rajul Patel, MD
Individual provider Active NPI Internal Medicine Physician · Suncity, AZ
NPI 1184635625 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1184635625
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 21742 (AZ)
- Practice address
- 10147W Grand Ave
Northwest Extension Clinic-VA
Suncity, AZ 85351 - Phone
- (602) 222-2630
- NPI assigned
- Aug 10, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150917000925 | AZ | Order and Referring Only - Internal Medicine |
1658553367 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21742 | AZ | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 21742 | AZ | Yes |
Addresses
Primary practice location
10147W Grand Ave
Northwest Extension Clinic-VA
Suncity, AZ 85351
Mailing address
1741 E Redfield Rd
Phoenix, AZ 85022-4569
Phone (602) 548-3273
Other providers in Suncity, AZ
All providers in Suncity, AZ · Internal Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.