Provider Demographics
NPI:1801196704
Name:PATEL, SHRUTI T (RPH)
Entity Type:Individual
Prefix:MISS
First Name:SHRUTI
Middle Name:T
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14939 SHADY GROVE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-7719
Mailing Address - Country:US
Mailing Address - Phone:301-944-1585
Mailing Address - Fax:301-944-1589
Practice Address - Street 1:14939 SHADY GROVE RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-7719
Practice Address - Country:US
Practice Address - Phone:301-944-1585
Practice Address - Fax:301-944-1589
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist