MEDICARE: BHAVESH PATEL

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
1	183500000X	Pharmacist	5302036813	MI

General Provider Information

NPI Number	:	1326329806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BHAVESH PATEL

Provider Business Mailing Address
First Line	:	8706 N TELEGRAPH RD
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-1457
Country	:	US
Telephone Number	:	313-724-9078
Fax Number	:

Provider Business Practice Location Address
First Line	:	8706 N TELEGRAPH RD
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-1457
Country	:	US
Telephone Number	:	313-724-9078
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2011
Last Update Date	:	08/29/2011

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Directions to “ BHAVESH PATEL ” Practice Location

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