Provider Demographics
NPI:1366776577
Name:ADVANCE MEDICAL HOME PHYSICIANS PLC
Entity type:Organization
Organization Name:ADVANCE MEDICAL HOME PHYSICIANS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANGITA
Authorized Official - Middle Name:C
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-250-9920
Mailing Address - Street 1:2888 E LONG LAKE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-7029
Mailing Address - Country:US
Mailing Address - Phone:248-250-9920
Mailing Address - Fax:248-250-9926
Practice Address - Street 1:2888 E LONG LAKE RD STE 150
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-7029
Practice Address - Country:US
Practice Address - Phone:248-250-9920
Practice Address - Fax:248-250-9926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI103524086Medicaid
MI103524086Medicaid
MIMI2171Medicare PIN