Healthcare Provider Details

I. General information

NPI: 1558616755
Provider Name (Legal Business Name): SHRUTI BHUPENDRA PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4745 OGLETOWN STANTON RD
NEWARK DE
19713-2067
US

IV. Provider business mailing address

4745 OGLETOWN STANTON RD
NEWARK DE
19713-2067
US

V. Phone/Fax

Practice location:
  • Phone: 302-738-5300
  • Fax:
Mailing address:
  • Phone: 302-738-5300
  • Fax: 302-731-4822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberC1-0013118
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: