Provider Demographics
NPI:1093717977
Name:PATEL, SHARDUL S (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:SHARDUL
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 810
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-0014
Mailing Address - Country:US
Mailing Address - Phone:978-806-0024
Mailing Address - Fax:978-494-4141
Practice Address - Street 1:34 HAVERHILL ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2884
Practice Address - Country:US
Practice Address - Phone:978-806-0024
Practice Address - Fax:978-494-4141
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23333183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist