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General NPI Number Information
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NPI Number | 1366408692
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Entity Type | Individual
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Provider Name | JASHU PATEL MD
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Gender | Male
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 205 PAGE AVE
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City | JACKSON
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State | MI
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Zip | 49201-2462
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Country | US
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Telephone | 517-787-3577
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Fax | 517-787-4280
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Provider Business Mailing Address
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Address Line | 6076 BROWNS LAKE RD
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City | JACKSON
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State | MI
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Zip | 49203-5609
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | JP046099
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License Number State | MI
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