Provider Demographics
NPI:1952326225
Name:PATEL, AMRISH K (MD)
Entity Type:Individual
Prefix:DR
First Name:AMRISH
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3600 W 13 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6711
Mailing Address - Country:US
Mailing Address - Phone:248-549-0777
Mailing Address - Fax:248-549-5888
Practice Address - Street 1:3600 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6711
Practice Address - Country:US
Practice Address - Phone:248-549-0777
Practice Address - Fax:248-549-5888
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI050602207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2614090Medicaid
MI0306316881OtherBLUE CROSS
MI2614090Medicaid
MI06316889031Medicare ID - Type Unspecified