Provider Demographics
NPI:1649595497
Name:PATEL, CHIRAG RAMESH (RPH)
Entity Type:Individual
Prefix:
First Name:CHIRAG
Middle Name:RAMESH
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12310 SINGLETREE LN
Mailing Address - Street 2:APT 2435
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7966
Mailing Address - Country:US
Mailing Address - Phone:586-362-1183
Mailing Address - Fax:952-435-1665
Practice Address - Street 1:14230 BURNHAVEN DR
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-4930
Practice Address - Country:US
Practice Address - Phone:952-435-8233
Practice Address - Fax:952-435-1665
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030434183500000X
MN118566183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist