Provider Demographics
NPI:1457839334
Name:PATEL, NIRALI MAHESH (REGISTER PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:NIRALI
Middle Name:MAHESH
Last Name:PATEL
Suffix:
Gender:F
Credentials:REGISTER PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23800 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:48183-3374
Mailing Address - Country:US
Mailing Address - Phone:734-675-4815
Mailing Address - Fax:
Practice Address - Street 1:23800 ALLEN RD
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:MI
Practice Address - Zip Code:48183-3374
Practice Address - Country:US
Practice Address - Phone:734-675-4815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033822183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist