Provider Demographics
NPI:1104106848
Name:PATEL, RONAK ARVINDKUMAR (PHARM D)
Entity type:Individual
Prefix:DR
First Name:RONAK
Middle Name:ARVINDKUMAR
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 BRINSTON DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-2594
Mailing Address - Country:US
Mailing Address - Phone:248-259-9217
Mailing Address - Fax:
Practice Address - Street 1:5789 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2959
Practice Address - Country:US
Practice Address - Phone:248-625-5271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302038870183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist