Individual
SUSHMA S PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17553 64TH PL N, MAPLE GROVE, MN 55311-4651
(312) 922-2138
Mailing address
17553 64TH PL N, MAPLE GROVE, MN 55311-4651
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
120291
MN
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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