Individual
DIVYA R PATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
2380 N FERGUSON AVE, SUITE 104, TUCSON, AZ 85712-2837
(520) 324-1010
(520) 324-0029
Mailing address
PO BOX 31235, TUCSON, AZ 85751-1235
(520) 324-4780
(520) 324-1406
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R72805
AZ
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
48561
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147298
—
AZ
Enumeration date
05/01/2013
Last updated
05/04/2017
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