Provider Demographics
NPI:1205158672
Name:PATEL, SHACHI (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SHACHI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7172 COLUMBIA GATEWAY DR.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21046
Mailing Address - Country:US
Mailing Address - Phone:888-662-6779
Mailing Address - Fax:
Practice Address - Street 1:7172 COLUMBIA GATEWAY DR STE 300
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2993
Practice Address - Country:US
Practice Address - Phone:888-662-6779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23003183500000X
NYI053791-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist