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General NPI Number Information
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NPI Number | 1225348584
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Entity Type | Organization
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Legal Business Name | PATEL FAMILY MEDICINE LLC
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 105 WATER ST
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City | PLYMOUTH
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State | IN
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Zip | 46563-2148
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Country | US
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Telephone | 574-936-3178
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Fax | 574-936-1084
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Provider Business Mailing Address
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Address Line | PO BOX 7412494
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City | CHICAGO
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State | IL
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Zip | 60674-2494
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Country | US
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Telephone | 248-607-0037
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Fax | 734-462-0344
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Authorized Official
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Title or Position | DIRECTOR OR RCM
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Name | KIMBERLY MILLER
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Credential |
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Telephone | 248-331-7908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 01063921A
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License Number State | IN
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