Individual
DIPA SUMAN PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
555 MIDTOWNE ST NE, SUITE 301, GRAND RAPIDS, MI 49503-5729
(616) 248-8864
(616) 248-8874
Mailing address
555 MIDTOWNE ST NE, SUITE 301, GRAND RAPIDS, MI 49503-5729
(616) 248-8864
(616) 248-8874
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301067695
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4217043
—
MI
05
—
4687596
—
MI
Enumeration date
07/26/2005
Last updated
03/18/2024
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