Healthcare Provider Details

I. General information

NPI: 1457112419
Provider Name (Legal Business Name): BHUMI PATEL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2024
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 COMMERCE DR STE 160
PERRYSBURG OH
43551-5272
US

IV. Provider business mailing address

4235 SECOR RD
TOLEDO OH
43623-4299
US

V. Phone/Fax

Practice location:
  • Phone: 419-872-7600
  • Fax: 419-872-7601
Mailing address:
  • Phone: 419-214-4214
  • Fax: 419-479-5593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0034999
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: