Provider Demographics
NPI:1285994582
Name:PATEL, SHACHI C (MD)
Entity type:Individual
Prefix:DR
First Name:SHACHI
Middle Name:C
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CENTURIAN DR STE 110
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2154
Mailing Address - Country:US
Mailing Address - Phone:302-355-0900
Mailing Address - Fax:302-355-0901
Practice Address - Street 1:1 CENTURIAN DR STE 110
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2154
Practice Address - Country:US
Practice Address - Phone:302-355-0900
Practice Address - Fax:302-355-0901
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283208207L00000X, 207LP2900X
PAMT201334207R00000X
390200000X
DEC1-0011950207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program