Healthcare Provider Details

I. General information

NPI: 1275680753
Provider Name (Legal Business Name): PROFESSIONAL OCCUPATIONAL AND ENVIRONMENTAL MEDICINE, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 05/25/2011
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 TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number4301078897
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number4301078897
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number4301078897
License Number StateMI

VIII. Authorized Official

Name: DR. BINDESH KIRITKUMAR PATEL
Title or Position: DOCTOR
Credential: M.D.
Phone: 734-934-4854