Healthcare Provider Details

I. General information

NPI: 1316474737
Provider Name (Legal Business Name): SACHIBEN PATEL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2017
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49650 CHERRY HILL RD STE 120
CANTON MI
48187-4850
US

IV. Provider business mailing address

49650 CHERRY HILL RD STE 120
CANTON MI
48187-4850
US

V. Phone/Fax

Practice location:
  • Phone: 343-987-8007
  • Fax: 910-272-7153
Mailing address:
  • Phone: 734-398-7800
  • Fax: 734-398-7805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101025818
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: