Provider Demographics
NPI:1578917597
Name:PATEL, DHAVALKUMAR DIPAKBHAI (RPH)
Entity Type:Individual
Prefix:
First Name:DHAVALKUMAR
Middle Name:DIPAKBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G3333 BEECHER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3619
Mailing Address - Country:US
Mailing Address - Phone:810-230-9900
Mailing Address - Fax:810-230-9988
Practice Address - Street 1:G3333 BEECHER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3619
Practice Address - Country:US
Practice Address - Phone:810-230-9900
Practice Address - Fax:810-230-9988
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302042643183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist