Healthcare Provider Details

I. General information

NPI: 1063478956
Provider Name (Legal Business Name): BINDESH K. PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 12/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 TELEGRAPH RD THE CENTER FOR WOUND HEALING & HYPERBARIC MEDICINE
TAYLOR MI
48180-3330
US

IV. Provider business mailing address

49025 WOODSON WAY
CANTON MI
48187-6673
US

V. Phone/Fax

Practice location:
  • Phone: 313-295-5343
  • Fax: 313-295-5315
Mailing address:
  • Phone: 734-934-4854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number4301078897
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number4301078897
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number120621
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number4301078897
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number120621
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number120621
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: