Provider Demographics
NPI:1972585248
Name:PATEL, HITEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:HITEN
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30400 TELEGRAPH RD
Mailing Address - Street 2:STE 324
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4540
Mailing Address - Country:US
Mailing Address - Phone:248-425-5202
Mailing Address - Fax:248-540-4937
Practice Address - Street 1:30400 TELEGRAPH RD
Practice Address - Street 2:STE 324
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4540
Practice Address - Country:US
Practice Address - Phone:248-426-9900
Practice Address - Fax:248-426-9950
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4300475812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1676919Medicaid
06312664261Medicare ID - Type Unspecified
MI1676919Medicaid