Provider Demographics
NPI:1396812541
Name:PATEL, NEETHI RAO (DO)
Entity type:Individual
Prefix:DR
First Name:NEETHI
Middle Name:RAO
Last Name:PATEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:NEETHI
Other - Middle Name:
Other - Last Name:RAO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:4967 CROOKS RD
Mailing Address - Street 2:STE 250
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098
Mailing Address - Country:US
Mailing Address - Phone:248-654-6499
Mailing Address - Fax:833-985-2159
Practice Address - Street 1:4967 CROOKS RD
Practice Address - Street 2:STE 250
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098
Practice Address - Country:US
Practice Address - Phone:248-654-6499
Practice Address - Fax:833-985-2159
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101014712208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics