Healthcare Provider Details

I. General information

NPI: 1730006453
Provider Name (Legal Business Name): SHAKSHIBEN PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3602 BRAINERD RD
CHATTANOOGA TN
37411-3601
US

IV. Provider business mailing address

3602 BRAINERD RD
CHATTANOOGA TN
37411-3601
US

V. Phone/Fax

Practice location:
  • Phone: 423-305-1858
  • Fax:
Mailing address:
  • Phone: 423-305-1858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number49801
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: