Provider Demographics
NPI:1710264841
Name:PATIL, MADHAVI V (RPH)
Entity Type:Individual
Prefix:
First Name:MADHAVI
Middle Name:V
Last Name:PATIL
Suffix:
Gender:F
Credentials:RPH
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Mailing Address - Street 1:13901 METROPOLITAN PARKWAY
Mailing Address - Street 2:WALGREENS #6636
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312
Mailing Address - Country:US
Mailing Address - Phone:586-446-8770
Mailing Address - Fax:586-446-9854
Practice Address - Street 1:13901 METROPOLITAN PARKWAY
Practice Address - Street 2:WALGREENS #6636
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312
Practice Address - Country:US
Practice Address - Phone:586-446-8770
Practice Address - Fax:586-446-9854
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5302028822183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist