Provider Demographics
NPI:1669765467
Name:SHAILESH PATEL MD LLC
Entity type:Organization
Organization Name:SHAILESH PATEL MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:770-337-0482
Mailing Address - Street 1:5454 YORKTOWNE DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-5317
Mailing Address - Country:US
Mailing Address - Phone:770-991-6044
Mailing Address - Fax:678-669-9738
Practice Address - Street 1:5454 YORKTOWNE DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-5317
Practice Address - Country:US
Practice Address - Phone:770-337-0482
Practice Address - Fax:678-669-9738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-26
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty