Provider Demographics
NPI:1124132642
Name:PATEL, SHEETAL (MD)
Entity type:Individual
Prefix:
First Name:SHEETAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112A ARGUS LN # 210
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6977
Mailing Address - Country:US
Mailing Address - Phone:814-598-2340
Mailing Address - Fax:704-970-1866
Practice Address - Street 1:80 CHURCH ST NE
Practice Address - Street 2:SUITE D
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4757
Practice Address - Country:US
Practice Address - Phone:814-598-2340
Practice Address - Fax:704-970-1866
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222403207R00000X, 208M00000X
OK40958208M00000X
NC2008-01334207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA204685284OtherUHC
MA467705OtherTUFTS
NC1124132642Medicaid
MA1159352OtherCIGNA
MA96710801OtherNETWORK HEALTH
MAAA31602OtherHPHC
MA510492088OtherUHC
MAAA90215OtherHPHC
NC1124132642OtherBCBSNC
MA7469581OtherAETNA
SCNC2340Medicaid
MA2089927Medicaid
MA96798OtherFALLON
NC5910135Medicaid
MA1124132642OtherBMC
MAJ28028OtherBCBS
MAJ28208OtherBLUE SHIELD
NCNCC416EMedicare PIN
NCNCC416FMedicare PIN
NC1124132642OtherBCBSNC
NC5910135Medicaid
MAJ28208OtherBLUE SHIELD
MAAA90215OtherHPHC
MA2089927Medicaid