Provider Demographics
NPI:1598368862
Name:PATEL, ALISHA CHETAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:CHETAN
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 1:1667 LODGETREE CV
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46280-2702
Mailing Address - Country:US
Mailing Address - Phone:731-225-7495
Mailing Address - Fax:
Practice Address - Street 1:1217 S RANGELINE RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2519
Practice Address - Country:US
Practice Address - Phone:317-843-4431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26028984A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist