Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Justin Patrick, PA

Individual provider Physician Assistant · NPI 1366120982

Justin Patrick, PA is a Physician Assistant in Southfield, Michigan. Qualified in 2023, 3 years ago. Practices with Hatahet Center PLLC, a 2-clinician group. Licensed in Michigan.

Years since qualifying
3
Licensed in
MI
In the registry since
2023
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

24725 W 12 Mile Rd Ste 260
Southfield, MI 48034-8310
Phone: (248) 382-8052
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601011860 (MI)

Record details

NPI number1366120982
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedJuly 5, 2023
Last updated in NPPESOctober 18, 2023
Certification dateOctober 18, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Hatahet Center Pllc — 2 clinicians
Accepts Medicare assignment Not indicated

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