MEDICARE: MIHIR PATEL

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1558055210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIHIR PATEL

Provider Business Mailing Address
First Line	:	45270 KEDING ST APT 303
Second Line	:
City	:	UTICA
State	:	MI
Zip	:	48317-6044
Country	:	US
Telephone Number	:	586-945-4521
Fax Number	:

Provider Business Practice Location Address
First Line	:	1175 W LONG LAKE RD STE 101102
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48098-4438
Country	:	US
Telephone Number	:	248-245-8728
Fax Number	:

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

Provider Enumeration Date	:	06/06/2023
Last Update Date	:	06/06/2023

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Directions to “ MIHIR PATEL ” Practice Location

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