MEDICARE: DIPAL MAHENDRABHAI PATEL PT, DPT

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	5501014630	MI

General Provider Information

NPI Number	:	1447734546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIPAL MAHENDRABHAI PATEL PT, DPT

Provider Business Mailing Address
First Line	:	42657 GREYSTONE DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48313-2978
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2251 N SQUIRREL RD STE 320
Second Line	:
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-4608
Country	:	US
Telephone Number	:	248-209-4970
Fax Number	:

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

Provider Enumeration Date	:	09/24/2018
Last Update Date	:	09/27/2018

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