Provider Demographics
NPI:1619152758
Name:SETH, NIMESH (PT)
Entity Type:Individual
Prefix:
First Name:NIMESH
Middle Name:
Last Name:SETH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2258 PLUMGROVE LN
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-1465
Mailing Address - Country:US
Mailing Address - Phone:734-834-1667
Mailing Address - Fax:248-562-7858
Practice Address - Street 1:6525 W MAPLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4930
Practice Address - Country:US
Practice Address - Phone:248-562-7846
Practice Address - Fax:248-562-7858
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013377225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist