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Prabhumallikarjun Patil, M.D

Psychiatry & Neurology, Neurology in Detroit, MI. Individual provider (NPI-1).

NPI number1124574009
StatusActive
Last updated in NPPESSep 8, 2022

Details

NPI
1124574009
Entity type
Individual (NPI-1)
Name
Prabhumallikarjun Patil
Credential
M.D
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 30, 2016
Certification date
Sep 8, 2022
Last updated
Sep 8, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084N0400X Psychiatry & Neurology, Neurology89832GAYes
390200000X Student in an Organized Health Care Education/Training Program4301110578MI

Practice location

930 E Lafayette St
Detroit, MI 48207-2938

Phone 313-680-9977

Mailing address

930 E Lafayette St
Detroit, MI 48207-2938

Phone 313-680-9977

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