Provider Demographics
NPI:1003871294
Name:PATEL, KIRITKUMAR CHHOTABHAI (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRITKUMAR
Middle Name:CHHOTABHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42557 WOODWARD AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-5206
Mailing Address - Country:US
Mailing Address - Phone:248-333-1170
Mailing Address - Fax:248-333-1175
Practice Address - Street 1:42557 WOODWARD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-5206
Practice Address - Country:US
Practice Address - Phone:248-333-1170
Practice Address - Fax:248-333-1175
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301048616207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700F37550OtherBCBSM
MIA78051OtherHAP
MI700F37550OtherBCN
MI4257960-10Medicaid
MIA78051Medicare UPIN
M89900005Medicare PIN