MEDICARE: DR. VIJAY C PATEL M.D.

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	207Q00000X	Family Medicine Physician	43010883722	MI

General Provider Information

NPI Number	:	1275678948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIJAY C PATEL M.D.

Provider Business Mailing Address
First Line	:	4020 VENOY RD STE 400
Second Line	:
City	:	WAYNE
State	:	MI
Zip	:	48184-1891
Country	:	US
Telephone Number	:	734-519-5200
Fax Number	:	734-519-5201

Provider Business Practice Location Address
First Line	:	4020 VENOY RD STE 400
Second Line	:
City	:	WAYNE
State	:	MI
Zip	:	48184-1891
Country	:	US
Telephone Number	:	734-519-5200
Fax Number	:	734-519-5201

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	02/27/2026

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