Provider Demographics
NPI:1053828780
Name:PATEL, MIHIR (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MIHIR
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5751 CLARKSTON RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-4707
Mailing Address - Country:US
Mailing Address - Phone:248-625-1015
Mailing Address - Fax:248-625-1354
Practice Address - Street 1:5751 CLARKSTON RD
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48348-4707
Practice Address - Country:US
Practice Address - Phone:248-625-1015
Practice Address - Fax:248-625-1354
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051300317183500000X
MI5302046150183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist