MEDICARE: DR. SHREYA M PATEL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	MD069816L	PA

General Provider Information

NPI Number	:	1205814480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHREYA M PATEL MD

Provider Business Mailing Address
First Line	:	1850 E PARK AVE
Second Line	:	STE 301
City	:	STATE COLLEGE
State	:	PA
Zip	:	16803-6706
Country	:	US
Telephone Number	:	814-237-3470
Fax Number	:	814-237-2035

Provider Business Practice Location Address
First Line	:	1850 E PARK AVE
Second Line	:	STE 301
City	:	STATE COLLEGE
State	:	PA
Zip	:	16803-6706
Country	:	US
Telephone Number	:	814-237-3470
Fax Number	:	814-237-2035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	08/14/2013

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