Basic Information
| Provider Information | |||||||||
| NPI: | 1033476189 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | KASHYAP | ||||||||
| MiddleName: | BABUBHAI | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28968 KATHRYN ST | ||||||||
| Address2: | |||||||||
| City: | GARDEN CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481352752 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 5333 MCAULEY DRIVE, SUITE 4001 | ||||||||
| Address2: | ACADEMIC INTERNAL MEDICINE | ||||||||
| City: | YPSILANTI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481978633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347123980 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2012 | ||||||||
| LastUpdateDate: | 06/02/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 13824 | ND | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 13824 | ND | N | Allopathic & Osteopathic Physicians | Hospitalist | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 01079621A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.