Provider Demographics
NPI:1407073927
Name:PATEL, HARSHIL SUBHASH
Entity Type:Individual
Prefix:
First Name:HARSHIL
Middle Name:SUBHASH
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 JONATHAN CIR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-3821
Mailing Address - Country:US
Mailing Address - Phone:586-604-0018
Mailing Address - Fax:586-949-6212
Practice Address - Street 1:50290 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48051-4003
Practice Address - Country:US
Practice Address - Phone:586-949-6110
Practice Address - Fax:586-949-6212
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302036656183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist