Provider Demographics
NPI:1568935047
Name:PATEL, BIJAL (MS)
Entity Type:Individual
Prefix:
First Name:BIJAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6239 GARNET LN APT SUITE
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7824
Mailing Address - Country:US
Mailing Address - Phone:810-344-9487
Mailing Address - Fax:
Practice Address - Street 1:6239 GARNET LN APT SUITE
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-7824
Practice Address - Country:US
Practice Address - Phone:810-344-9487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201006982225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist