Provider Demographics
NPI:1053109777
Name:PATEL, SHLOK
Entity type:Individual
Prefix:
First Name:SHLOK
Middle Name:
Last Name:PATEL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1638 LAKE WATEREE DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-8160
Mailing Address - Country:US
Mailing Address - Phone:843-617-4411
Mailing Address - Fax:
Practice Address - Street 1:1050 SOUTHERN DR APT 1905B
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-5645
Practice Address - Country:US
Practice Address - Phone:843-617-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician