MEDICARE: DR. ANOOP A PATEL MD

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	4301050825	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	382032989	OTHER	MI	COMMERCIAL
2	340H275000	OTHER	MI	BLUE CROSS OF MICHIGAN

General Provider Information

NPI Number	:	1841274958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANOOP A PATEL MD

Provider Business Mailing Address
First Line	:	5700 SOUTHWYCK BLVD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-1509
Country	:	US
Telephone Number	:	800-678-1861
Fax Number	:

Provider Business Practice Location Address
First Line	:	7733 E JEFFERSON AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48214-3707
Country	:	US
Telephone Number	:	313-499-3000
Fax Number	:

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

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	10/31/2013

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