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General NPI Number Information
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NPI Number | 1861966244
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE CARE MEDICAL GROUP OF MI, PLLC
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Dates
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Enumeration Date | 01/18/2019
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 2815 NORTHWIND DR
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City | EAST LANSING
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State | MI
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Zip | 48823-5003
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Country | US
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Telephone | 800-860-3274
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1040
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City | SYOSSET
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State | NY
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Zip | 11791-0010
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Country | US
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Telephone | 800-860-3274
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Fax | 888-910-1059
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Authorized Official
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Title or Position | OWNER
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Name | DEEPAK RAMESHCHANDRA PATEL
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Credential |
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Telephone | 212-734-6621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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