1740034784 NPI number — DR. RAVI KANUBHAI PATEL M.D.

Table of content: DR. RAVI KANUBHAI PATEL M.D. (NPI 1740034784)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740034784 NPI number — DR. RAVI KANUBHAI PATEL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATEL
Provider First Name:
RAVI
Provider Middle Name:
KANUBHAI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740034784
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44405 WOODWARD AVE. TRINITY HEALTH OAKLAND
Provider Second Line Business Mailing Address:
GRADUATE MEDICAL EDUCATION DEPT.
Provider Business Mailing Address City Name:
PONTIAC
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48341
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44405 WOODWARD AVENUE TRINITY HEALTH OAKLAND
Provider Second Line Business Practice Location Address:
DEPARTMENT OF INTERNAL MEDICINE
Provider Business Practice Location Address City Name:
PONTIAC
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48341
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-858-6233
Provider Business Practice Location Address Fax Number:
248-858-3244
Provider Enumeration Date:
04/16/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)