Provider Demographics
NPI:1306373618
Name:PATEL, SHIVANI DIPAK
Entity type:Individual
Prefix:
First Name:SHIVANI
Middle Name:DIPAK
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7702 E PARHAM RD STE 201
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4372
Mailing Address - Country:US
Mailing Address - Phone:540-798-8785
Mailing Address - Fax:
Practice Address - Street 1:7702 E PARHAM RD STE 201
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4372
Practice Address - Country:US
Practice Address - Phone:804-799-5930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022179181835P0018X
183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183700000XPharmacy Service ProvidersPharmacy Technician