Provider Demographics
NPI:1770183949
Name:PATEL, ANJANA HASMUKH
Entity Type:Individual
Prefix:
First Name:ANJANA
Middle Name:HASMUKH
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8555 OLD OAK CIR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-4509
Mailing Address - Country:US
Mailing Address - Phone:773-396-2955
Mailing Address - Fax:
Practice Address - Street 1:412 OAKS XING
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-1900
Practice Address - Country:US
Practice Address - Phone:269-685-9820
Practice Address - Fax:269-685-9850
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302036341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist