Provider Demographics
NPI:1306949318
Name:PATEL, SHOBHA N (MD)
Entity type:Individual
Prefix:MRS
First Name:SHOBHA
Middle Name:N
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6522 E CARONDELET DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2200
Mailing Address - Country:US
Mailing Address - Phone:520-886-8239
Mailing Address - Fax:520-885-1705
Practice Address - Street 1:6522 E CARONDELET DR
Practice Address - Street 2:SUITE B
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2200
Practice Address - Country:US
Practice Address - Phone:520-886-8239
Practice Address - Fax:520-885-1705
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2008-04-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ8025207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ86031593585710A001OtherTRICARE
AZ49522680027OtherME#
AZ0479159OtherAETNA
AZ86031593500OtherPACIFICARE
AZAZ0055910OtherBC/BS
AZ860315935 0009OtherCIGNA
AZ0479159OtherAETNA