Provider Demographics
NPI:1982119764
Name:PATEL, SHWETA PRAKUNJ
Entity type:Individual
Prefix:MRS
First Name:SHWETA
Middle Name:PRAKUNJ
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2416 FAULKS CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:WINGATE
Mailing Address - State:NC
Mailing Address - Zip Code:28174-7707
Mailing Address - Country:US
Mailing Address - Phone:704-254-0499
Mailing Address - Fax:
Practice Address - Street 1:720 E US HIGHWAY 74
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-7206
Practice Address - Country:US
Practice Address - Phone:910-582-3996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-03
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist