MEDICARE: JEET VIJAY 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	163W00000X	Registered Nurse	4704383840	MI

General Provider Information

NPI Number	:	1639024714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEET VIJAY PATEL

Provider Business Mailing Address
First Line	:	4020 VENOY RD STE 400
Second Line	:
City	:	WAYNE
State	:	MI
Zip	:	48184-1891
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4020 VENOY RD STE 400
Second Line	:
City	:	WAYNE
State	:	MI
Zip	:	48184-1891
Country	:	US
Telephone Number	:	734-519-5200
Fax Number	:

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

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ JEET VIJAY PATEL ” Practice Location

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