Healthcare Provider Details

I. General information

NPI: 1477871622
Provider Name (Legal Business Name): DHIMANKUMAR PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 E MICHIGAN AVE
YPSILANTI MI
48198
US

IV. Provider business mailing address

1717 E MICHIGAN AVE
YPSILANTI MI
48198
US

V. Phone/Fax

Practice location:
  • Phone: 734-482-9342
  • Fax: 734-483-8649
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302038365
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: