Healthcare Provider Details

I. General information

NPI: 1528190782
Provider Name (Legal Business Name): HEMLATTA PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28659 TELEGRAPH RD
FLAT ROCK MI
48134-1507
US

IV. Provider business mailing address

31853 LAVENDER DR
BROWNSTOWN MI
48173-8741
US

V. Phone/Fax

Practice location:
  • Phone: 734-783-2572
  • Fax: 734-782-3991
Mailing address:
  • Phone: 734-783-2572
  • Fax: 734-782-3991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302033380
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: