Provider Demographics
NPI:1336123603
Name:PATEL, DIPIKA G (DPM)
Entity Type:Individual
Prefix:DR
First Name:DIPIKA
Middle Name:G
Last Name:PATEL
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32743 23 MILE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-2176
Mailing Address - Country:US
Mailing Address - Phone:708-424-3201
Mailing Address - Fax:708-424-5001
Practice Address - Street 1:10530 WOLFPEN-PLEASANT HILL RD
Practice Address - Street 2:SUITE E
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150
Practice Address - Country:US
Practice Address - Phone:513-831-7503
Practice Address - Fax:513-831-7923
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2022-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003400213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00257869OtherMEDICARE RAILROAD
OH2607870Medicaid
P00257869OtherMEDICARE RAILROAD
OHV06029Medicare UPIN
0698420005Medicare NSC
0698420006Medicare NSC
PA4166123Medicare PIN
0698420015Medicare NSC
OH2607870Medicaid
0698420002Medicare NSC
OH4166123Medicare PIN