Provider Demographics
NPI:1912164005
Name:PATEL, NILESHKUMAR RAMESHBHAI (RPT)
Entity type:Individual
Prefix:MR
First Name:NILESHKUMAR
Middle Name:RAMESHBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:555 S MISSION ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2846
Mailing Address - Country:US
Mailing Address - Phone:989-772-7766
Mailing Address - Fax:989-772-4342
Practice Address - Street 1:555 S MISSION ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2846
Practice Address - Country:US
Practice Address - Phone:989-772-7766
Practice Address - Fax:989-772-4342
Is Sole Proprietor?:No
Enumeration Date:2008-05-18
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013442225100000X
MO2014043817225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist