Healthcare Provider Details

I. General information

NPI: 1346886447
Provider Name (Legal Business Name): HARDIK YOGENDRABHAI PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2019
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5990 SASHABAW RD
CLARKSTON MI
48346-3154
US

IV. Provider business mailing address

4877 PEBBLE CRK E APT 6
SHELBY TOWNSHIP MI
48317-6201
US

V. Phone/Fax

Practice location:
  • Phone: 248-922-3704
  • Fax: 248-922-3715
Mailing address:
  • Phone: 330-212-3546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302046953
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: