Healthcare Provider Details

I. General information

NPI: 1982920963
Provider Name (Legal Business Name): SHALIN PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2010
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 TOWN CENTER DR STE 405
RESTON VA
20190-3218
US

IV. Provider business mailing address

1830 TOWN CENTER DR STE 400
RESTON VA
20190-3292
US

V. Phone/Fax

Practice location:
  • Phone: 703-481-3165
  • Fax:
Mailing address:
  • Phone:
  • Fax: 571-423-5082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD-18573
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD-18573
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: