Provider Demographics
NPI:1184737819
Name:PATEL, AMAR N (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:AMAR
Middle Name:N
Last Name:PATEL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25147 W WARREN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2198
Mailing Address - Country:US
Mailing Address - Phone:313-277-5508
Mailing Address - Fax:313-277-5535
Practice Address - Street 1:25147 W WARREN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2198
Practice Address - Country:US
Practice Address - Phone:313-277-5508
Practice Address - Fax:313-277-5535
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501009549225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501009549OtherBUREAU OF HEALTH SERVICES, STATE OF MICHIGAN
MI5501009549OtherBUREAU OF HEALTH SERVICES, STATE OF MICHIGAN