Provider Demographics
NPI:1831701671
Name:PURE PSYCHIATRY OF MICHIGAN PLLC
Entity type:Organization
Organization Name:PURE PSYCHIATRY OF MICHIGAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIANS ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SARANG
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-292-7640
Mailing Address - Street 1:34841 VETERANS PLAZA
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:MI
Mailing Address - Zip Code:48184-1733
Mailing Address - Country:US
Mailing Address - Phone:313-292-7640
Mailing Address - Fax:313-292-9270
Practice Address - Street 1:34841 VETERANS PLAZA
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184-1733
Practice Address - Country:US
Practice Address - Phone:313-292-7640
Practice Address - Fax:313-292-9270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-22
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty