Provider Demographics
NPI:1598716995
Name:PATEL, SHASHANK CHANDULAL (MD)
Entity Type:Individual
Prefix:DR
First Name:SHASHANK
Middle Name:CHANDULAL
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5245 BUFORD HWY
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-2621
Mailing Address - Country:US
Mailing Address - Phone:770-447-5551
Mailing Address - Fax:770-447-9521
Practice Address - Street 1:5245 BUFORD HWY
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-2621
Practice Address - Country:US
Practice Address - Phone:770-447-5551
Practice Address - Fax:770-447-9521
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL12628207RP1001X
GA29510207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA136983098CMedicaid
AL051537547Medicare PIN
ALF44645Medicare UPIN