Healthcare Provider Details
I. General information
NPI: 1679637946
Provider Name (Legal Business Name): NILESH SHANTILAL PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/21/2006
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
900 E OAK HILL AVE
KNOXVILLE TN
37917-4505
US
IV. Provider business mailing address
10200 GRAND CENTRAL AVE STE 220
OWINGS MILLS MD
21117-4366
US
V. Phone/Fax
- Phone: 865-859-7020
- Fax: 865-859-3706
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | 054850 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | 42003 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: