MEDICARE: NIRAV PATEL PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5501014918	MI

General Provider Information

NPI Number	:	1114267697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIRAV PATEL PT

Provider Business Mailing Address
First Line	:	5384 DANIELS DR
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48098-3006
Country	:	US
Telephone Number	:	248-752-5123
Fax Number	:

Provider Business Practice Location Address
First Line	:	10636 W 7 MILE RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48221-1969
Country	:	US
Telephone Number	:	313-862-1340
Fax Number	:	313-862-1329

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2013
Last Update Date	:	09/01/2016

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Directions to “ NIRAV PATEL PT” Practice Location

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