MEDICARE: DR. SAPNA R PATEL M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	4301075776	MI
2	207RX0202X	Medical Oncology Physician	4301075776	MI

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00923035	OTHER	MI	RR MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1538397120	OTHER	MI	GROUP NPI
4	27-0381199	OTHER	MI	GROUP TAX ID

NPI Number	:	1801830732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAPNA R PATEL M.D.

Provider Business Mailing Address
First Line	:	3900 HOLLYWOOD RD
Second Line	:
City	:	SAINT JOSEPH
State	:	MI
Zip	:	49085-9149
Country	:	US
Telephone Number	:	269-428-4411
Fax Number	:	269-428-4422

Provider Business Practice Location Address
First Line	:	3900 HOLLYWOOD RD
Second Line	:	MARIE YEAGER CANCER CENTER
City	:	SAINT JOSEPH
State	:	MI
Zip	:	49085-9149
Country	:	US
Telephone Number	:	269-428-4411
Fax Number	:	269-438-4422

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	08/23/2023

3900 HOLLYWOOD RD , MARIE YEAGER CANCER CENTER
SAINT JOSEPH, MI
49085-9149

Practice Phone: 269-428-4411
Practice Fax: 269-428-4422

3903 HOLLYWOOD RD
SAINT JOSEPH, MI
49085-9149