Healthcare Provider Details

I. General information

NPI: 1346859030
Provider Name (Legal Business Name): SHIEL PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 01/15/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1498 JESSE JEWELL PKWY SE STE A
GAINESVILLE GA
30501-3874
US

IV. Provider business mailing address

3235 SATELLITE BLVD STE 104
DULUTH GA
30096-8688
US

V. Phone/Fax

Practice location:
  • Phone: 678-257-2547
  • Fax: 866-317-9099
Mailing address:
  • Phone: 404-819-7424
  • Fax: 866-317-9099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberGA86554
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberGA86554
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: