Provider Demographics
NPI:1023661576
Name:CHESTNUT HEALTH OF MICHIGAN, PLLC
Entity type:Organization
Organization Name:CHESTNUT HEALTH OF MICHIGAN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:KISHOR
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:224-760-7322
Mailing Address - Street 1:41000 WOODWARD AVE.
Mailing Address - Street 2:SUITE 350 EAST
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-5092
Mailing Address - Country:US
Mailing Address - Phone:224-760-7322
Mailing Address - Fax:224-535-8252
Practice Address - Street 1:41000 WOODWARD AVE.
Practice Address - Street 2:SUITE 350 EAST
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-5092
Practice Address - Country:US
Practice Address - Phone:224-760-7322
Practice Address - Fax:224-535-8252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty