Basic Information
| Provider Information | |||||||||
| NPI: | 1417192907 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SHODHAN PATEL MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4800 ROWAN RD | ||||||||
| Address2: | |||||||||
| City: | NEW PORT RICHEY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346535609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7274835912 | ||||||||
| FaxNumber: | 7273763652 | ||||||||
| Practice Location | |||||||||
| Address1: | 4800 ROWAN RD | ||||||||
| Address2: | |||||||||
| City: | NEW PORT RICHEY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346535609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7274835912 | ||||||||
| FaxNumber: | 7273763652 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2008 | ||||||||
| LastUpdateDate: | 11/10/2015 | ||||||||
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| AuthorizedOfficialLastName: | PATEL | ||||||||
| AuthorizedOfficialFirstName: | SHODHAN | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PSYCHIATRIST | ||||||||
| AuthorizedOfficialTelephone: | 8139660177 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | ME65091 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.