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NPI Code Detail

MEDICARE: MR. BHAVESHKUMAR J PATEL RPT

MEDICARE: MR. BHAVESHKUMAR J PATEL RPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5501013441MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15501013441OTHERMISTATE OF MICHIGAN

General Provider Information

NPI Number : 1083949630
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BHAVESHKUMAR J PATEL RPT
Provider Business Mailing Address
First Line : 752 HIDDEN RIDGE DR
Second Line :
City : TROY
State : MI
Zip : 48083-5127
Country : US
Telephone Number : 989-560-0123
Fax Number :
Provider Business Practice Location Address
First Line : 20555 VICTOR PKWY
Second Line :
City : LIVONIA
State : MI
Zip : 48152-7031
Country : US
Telephone Number : 734-343-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2009
Last Update Date : 08/16/2023

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