Healthcare Provider Details

I. General information

NPI: 1528487022
Provider Name (Legal Business Name): SHEYLAN PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2014
Last Update Date: 07/21/2022
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 19TH ST S
BIRMINGHAM AL
35249-3003
US

IV. Provider business mailing address

3480 WAKE FOREST RD STE 414
RALEIGH NC
27609-7376
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-4328
  • Fax:
Mailing address:
  • Phone: 205-934-4328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2020-00256
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: