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General NPI Number Information
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NPI Number | 1124439427
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Entity Type | Individual
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Provider Name | SHYAM PATEL MD
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Gender | Male
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Dates
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Enumeration Date | 05/08/2014
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 502 CENTENNIAL BLVD STE 3
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City | VOORHEES
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State | NJ
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Zip | 08043-9544
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Country | US
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Telephone | 856-751-2300
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Fax | 856-751-2333
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Provider Business Mailing Address
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Address Line | 335 RIGHTERS FERRY RD APT 410
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1747
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Country | US
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Telephone | 908-448-9686
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD473447
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 25MA11503400
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License Number State | NJ
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