Individual
PRABHUMALLIKARJUN PATIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
930 E LAFAYETTE ST, DETROIT, MI 48207-2938
(313) 680-9977
Mailing address
930 E LAFAYETTE ST, DETROIT, MI 48207-2938
(313) 680-9977
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
89832
GA
390200000X
Student in an Organized Health Care Education/Training Program
4301110578
MI
Other
Enumeration date
08/30/2016
Last updated
09/08/2022
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