Provider Demographics
NPI:1942362694
Name:ALLERGY & ASTHMA PHYSICIANS OF ROYAL OAK PC
Entity type:Organization
Organization Name:ALLERGY & ASTHMA PHYSICIANS OF ROYAL OAK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BHAVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-651-1133
Mailing Address - Street 1:950 W AVON RD
Mailing Address - Street 2:SUITE # A-5
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2761
Mailing Address - Country:US
Mailing Address - Phone:248-651-1133
Mailing Address - Fax:248-651-5004
Practice Address - Street 1:3600 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6711
Practice Address - Country:US
Practice Address - Phone:248-549-0777
Practice Address - Fax:248-549-5422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4624353Medicaid
MI4624353Medicaid