Provider Demographics
NPI:1528190782
Name:PATEL, HEMLATTA
Entity Type:Individual
Prefix:
First Name:HEMLATTA
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 1:31853 LAVENDER DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48173-8741
Mailing Address - Country:US
Mailing Address - Phone:734-783-2572
Mailing Address - Fax:734-782-3991
Practice Address - Street 1:28659 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:FLAT ROCK
Practice Address - State:MI
Practice Address - Zip Code:48134-1507
Practice Address - Country:US
Practice Address - Phone:734-783-2572
Practice Address - Fax:734-782-3991
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist