Provider Demographics
NPI:1689800112
Name:PATEL, AMISH J (DO)
Entity Type:Individual
Prefix:DR
First Name:AMISH
Middle Name:J
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 WEST 13 MILE ROAD
Mailing Address - Street 2:SUITE 437
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6700
Mailing Address - Country:US
Mailing Address - Phone:248-288-2210
Mailing Address - Fax:248-589-9875
Practice Address - Street 1:3535 WEST 13 MILE ROAD
Practice Address - Street 2:SUITE 437
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6700
Practice Address - Country:US
Practice Address - Phone:248-288-2210
Practice Address - Fax:248-589-9875
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010180962081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine