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General NPI Number Information
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NPI Number | 1598716995
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Entity Type | Individual
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Provider Name | SHASHANK CHANDULAL PATEL MD
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Gender | Male
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 5245 BUFORD HWY
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City | NORCROSS
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State | GA
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Zip | 30071-2621
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Country | US
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Telephone | 770-447-5551
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Fax | 770-447-9521
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Provider Business Mailing Address
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Address Line | 5245 BUFORD HWY
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City | NORCROSS
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State | GA
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Zip | 30071-2621
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Country | US
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Telephone | 770-447-5551
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Fax | 770-447-9521
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 12628
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 29510
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License Number State | GA
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