Healthcare Provider Details

I. General information

NPI: 1184136772
Provider Name (Legal Business Name): DR. SHREYAS DILIP PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MR. SHREYAS DILIPBHAI PATEL

II. Dates (important events)

Enumeration Date: 11/03/2017
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9871 GEORGETOWN PIKE
GREAT FALLS VA
22066-2617
US

IV. Provider business mailing address

22811 TAWNY PINE SQ
BRAMBLETON VA
20148-5811
US

V. Phone/Fax

Practice location:
  • Phone: 703-759-2428
  • Fax:
Mailing address:
  • Phone: 919-413-2191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number27456
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202222056
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: