Provider Demographics
NPI:1407856438
Name:PATEL, SHILPA J (OD, MS, PHD)
Entity Type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:J
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD, MS, PHD
Other - Prefix:
Other - First Name:SHILPA
Other - Middle Name:J
Other - Last Name:REGISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1009 MONTGOMERY HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2860
Mailing Address - Country:US
Mailing Address - Phone:205-397-9400
Mailing Address - Fax:
Practice Address - Street 1:1009 MONTGOMERY HWY STE 200
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-2860
Practice Address - Country:US
Practice Address - Phone:205-397-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS967TA525152W00000X
MA4423152W00000X
ALS-967-TA-525152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA70092YMedicaid
MA70092YMedicaid
MA37702Medicare ID - Type Unspecified