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Individual
SANDEEP MALLANAGOUDA PATIL
Active
Individual
SANDEEP MALLANAGOUDA PATIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
202074
LA
207RN0300X
Nephrology Physician
Primary
50371
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030611
—
AZ
Enumeration date
08/18/2008
Last updated
11/03/2025
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