Provider Demographics
NPI:1063403103
Name:PATEL, SANDHYA D (MD)
Entity type:Individual
Prefix:DR
First Name:SANDHYA
Middle Name:D
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31500 TELEGRAPH RD
Mailing Address - Street 2:STE 105
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4367
Mailing Address - Country:US
Mailing Address - Phone:248-540-8700
Mailing Address - Fax:248-540-8701
Practice Address - Street 1:31500 TELEGRAPH RD
Practice Address - Street 2:STE 105
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4367
Practice Address - Country:US
Practice Address - Phone:248-540-8700
Practice Address - Fax:248-540-8701
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301067891208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4100425Medicaid
0M88120Medicare ID - Type Unspecified
H04419Medicare UPIN