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General NPI Number Information
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NPI Number | 1679737761
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Entity Type | Individual
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Provider Name | SHAILESH K GOHEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 02/05/2019
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Provider Practice Location Address
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Address Line | 3733 FETTLER PARK DR
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City | DUMFRIES
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State | VA
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Zip | 22025
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Country | US
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Telephone | 703-670-0300
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Fax | 703-291-5331
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Provider Business Mailing Address
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Address Line | 3733 FETTLER PARK DR
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City | DUMFRIES
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State | VA
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Zip | 22025-2048
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Country | US
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Telephone | 703-670-0300
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Fax | 703-291-5331
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MT192780
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MA08429900
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101244499
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License Number State | VA
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