Provider Demographics
NPI:1912567819
Name:PATEL, VILPESH K
Entity Type:Individual
Prefix:
First Name:VILPESH
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:VILPESH
Other - Middle Name:K
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:48760 VENETO DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-9385
Mailing Address - Country:US
Mailing Address - Phone:734-233-1597
Mailing Address - Fax:
Practice Address - Street 1:23241 EUREKA RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-5240
Practice Address - Country:US
Practice Address - Phone:734-287-3880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031572183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist