Individual
MITULKUMAR P PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4880 WYNN RD, LAS VEGAS, NV 89103-5406
(702) 871-5005
(702) 671-6883
Mailing address
PO BOX 1737, LAS VEGAS, NV 89125-1737
(702) 671-6809
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10855
NV
207R00000X
Internal Medicine Physician
G74858
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100507193
—
NV
01
—
10855
MEDICAL LICENSE
NV
01
—
CS12512
PHARMACY/CONTROLLED SUBSTANCE CERTIFICATE
NV
Enumeration date
09/20/2005
Last updated
03/07/2023
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