Provider Demographics
NPI:1679646368
Name:RANPURIA, SHEPHALI KANTILAL (MD)
Entity Type:Individual
Prefix:
First Name:SHEPHALI
Middle Name:KANTILAL
Last Name:RANPURIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHEPHALI
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8501 WEDDERBURN STATION DR
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-6875
Mailing Address - Country:US
Mailing Address - Phone:713-689-9634
Mailing Address - Fax:
Practice Address - Street 1:1915 I ST NW STE 700
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-2120
Practice Address - Country:US
Practice Address - Phone:202-251-7541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4909207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX211943001Medicaid
TXI72717Medicare UPIN
TX211943001Medicaid