Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 4301407611 | MI |
NPI | 1558461426 |
---|---|
Provider Name | Dr. Bharat Kumar Patel |
First Address | Saint Clair Shores, MI 48080-3607 |
Second Address | Saint Clair Shores, MI 48080-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 04/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1105043052 | BLUE CROSS BLUE SHIELD (01) | MI |
2574780-10 | (05) | MI |
382878216 | COMMERCIAL (01) | MI |
E38269 | (02) | MI |