Provider Demographics
NPI:1992729958
Name:PATEL, MALATI ARUN KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:MALATI
Middle Name:ARUN KUMAR
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18645 CANAL RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-5822
Mailing Address - Country:US
Mailing Address - Phone:586-286-4004
Mailing Address - Fax:586-286-1225
Practice Address - Street 1:18645 CANAL RD
Practice Address - Street 2:SUITE 3
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-5822
Practice Address - Country:US
Practice Address - Phone:586-286-4004
Practice Address - Fax:586-286-1225
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIMP042950207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2117236Medicaid
MI2117236Medicaid
05001151161Medicare ID - Type Unspecified