Provider Demographics
NPI:1326827544
Name:PATEL, SHIVANI (DC)
Entity Type:Individual
Prefix:
First Name:SHIVANI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10630 LITTLE PATUXENT PKWY STE 329
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3204
Mailing Address - Country:US
Mailing Address - Phone:443-718-9432
Mailing Address - Fax:443-718-4532
Practice Address - Street 1:10630 LITTLE PATUXENT PKWY STE 329
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3204
Practice Address - Country:US
Practice Address - Phone:443-718-9432
Practice Address - Fax:443-718-4532
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04189111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor