Provider Demographics
NPI:1881727030
Name:PATEL, PIYUSH BHOLABHAI (RPH)
Entity type:Individual
Prefix:MR
First Name:PIYUSH
Middle Name:BHOLABHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4542 GULL PRAIRIE PL 2B
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-3091
Mailing Address - Country:US
Mailing Address - Phone:269-558-1518
Mailing Address - Fax:269-552-9210
Practice Address - Street 1:4542 GULL PRAIRIE PL APT 2B
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-3091
Practice Address - Country:US
Practice Address - Phone:269-552-1518
Practice Address - Fax:269-552-9210
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035101183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist