Individual
SANDEEP MALLANAGOUDA PATIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1910 S STAPLEY DR STE 120, MESA, AZ 85204-6676
(602) 525-5674
Mailing address
2040 S ALMA SCHOOL RD STE 1, CHANDLER, AZ 85286-7076
(480) 290-1822
(949) 864-3908
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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