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NPI Code Detail

MEDICARE: PANKAJKUMAR RAMESHBHAI PATEL

MEDICARE:   PANKAJKUMAR RAMESHBHAI 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
1183500000XPharmacist5302035431MI

General Provider Information

NPI Number : 1912131491
Entity Type Code : Individual
Provider Name (Legal Business Name) : PANKAJKUMAR RAMESHBHAI PATEL
Provider Business Mailing Address
First Line : 4365 NEWARK CIR
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-2510
Country : US
Telephone Number : 810-606-8456
Fax Number : 810-424-3565
Provider Business Practice Location Address
First Line : 4365 NEWARK CIR
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-2510
Country : US
Telephone Number : 810-606-8456
Fax Number : 810-424-3565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2009
Last Update Date : 05/12/2009

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Directions to “ PANKAJKUMAR RAMESHBHAI PATEL ” Practice Location

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