Provider Demographics
NPI:1528293412
Name:PATEL, ASHOK (RPT)
Entity type:Individual
Prefix:
First Name:ASHOK
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27160 GATEWAY DR S
Mailing Address - Street 2:APT 112
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-4959
Mailing Address - Country:US
Mailing Address - Phone:248-345-3674
Mailing Address - Fax:
Practice Address - Street 1:27160 GATEWAY DR S
Practice Address - Street 2:APT 112
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-4959
Practice Address - Country:US
Practice Address - Phone:248-345-3674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1358093225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist