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General NPI Number Information
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NPI Number | 1801496906
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Entity Type | Individual
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Provider Name | SANJAY PATEL
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Gender | Male
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Dates
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Enumeration Date | 10/28/2020
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 2150 N TELEGRAPH RD
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City | MONROE
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State | MI
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Zip | 48162-8901
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Country | US
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Telephone | 734-242-2385
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Fax | 734-242-2389
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Provider Business Mailing Address
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Address Line | 49356 TOWNSEND CT
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City | CANTON
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State | MI
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Zip | 48187-5806
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Country | US
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Telephone | 734-331-5995
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302037343
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License Number State | MI
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