Basic Information
| Provider Information | |||||||||
| NPI: | 1720471634 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FIELDS | ||||||||
| FirstName: | SHANILA | ||||||||
| MiddleName: | PATEL | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 404 S SUTHERLAND AVE | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281125060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042919267 | ||||||||
| FaxNumber: | 7042837939 | ||||||||
| Practice Location | |||||||||
| Address1: | 404 S SUTHERLAND AVE | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281125060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042919267 | ||||||||
| FaxNumber: | 7042837939 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2015 | ||||||||
| LastUpdateDate: | 06/26/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 001005503 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.