Provider Demographics
NPI:1467729962
Name:PATEL, SHAMEEL SUBHASH (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAMEEL
Middle Name:SUBHASH
Last Name:PATEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 E JACKSON ST
Mailing Address - Street 2:#B
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-5194
Mailing Address - Country:US
Mailing Address - Phone:229-227-0026
Mailing Address - Fax:229-227-1523
Practice Address - Street 1:327 E JACKSON ST
Practice Address - Street 2:#B
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-5194
Practice Address - Country:US
Practice Address - Phone:229-227-0026
Practice Address - Fax:229-227-1523
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008903111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor