Provider Demographics
NPI:1871800532
Name:PATEL, GHANSHYAM G
Entity type:Individual
Prefix:MR
First Name:GHANSHYAM
Middle Name:G
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 E PADONIA RD
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2306
Mailing Address - Country:US
Mailing Address - Phone:410-252-8901
Mailing Address - Fax:410-683-0592
Practice Address - Street 1:35 E PADONIA RD
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2306
Practice Address - Country:US
Practice Address - Phone:410-252-8901
Practice Address - Fax:410-683-0592
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2010-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10562183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist