Provider Demographics
NPI:1235441239
Name:PATEL, SHIVANI J (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHIVANI
Middle Name:J
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5975 WEDDINGTON-MONROE RD
Mailing Address - Street 2:WALGREENS 10255
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5975 WEDDINGTON-MONROE RD
Practice Address - Street 2:WALGREENS 10255
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104
Practice Address - Country:US
Practice Address - Phone:704-684-6036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist