Provider Demographics
NPI:1407146731
Name:PATEL, NEHAL
Entity Type:Individual
Prefix:
First Name:NEHAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3681 SHAWNEE RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGMAN
Mailing Address - State:MI
Mailing Address - Zip Code:49106-9713
Mailing Address - Country:US
Mailing Address - Phone:269-465-6777
Mailing Address - Fax:
Practice Address - Street 1:3681 SHAWNEE RD
Practice Address - Street 2:
Practice Address - City:BRIDGMAN
Practice Address - State:MI
Practice Address - Zip Code:49106-9713
Practice Address - Country:US
Practice Address - Phone:269-465-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1777533183500000X
NC20517183500000X
IL051.294766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist