MEDICARE: SHASHANK G PATEL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	D0058962	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952340648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHASHANK G PATEL MD

Provider Business Mailing Address
First Line	:	18121 GEORGIA AVE SUITE 103
Second Line	:	ADVANCED INTERNAL MEDICINE PC
City	:	OLNEY
State	:	MD
Zip	:	20832
Country	:	US
Telephone Number	:	301-933-5050
Fax Number	:	301-949-3262

Provider Business Practice Location Address
First Line	:	18121 GEORGIA AVE STE 103
Second Line	:
City	:	OLNEY
State	:	MD
Zip	:	20832-1437
Country	:	US
Telephone Number	:	301-933-5050
Fax Number	:	301-949-3262

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	03/07/2023

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Directions to “ SHASHANK G PATEL MD” Practice Location

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