Individual
MS. SHASTA PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
8900 COLUMBIA 100 PKWY STE G, COLUMBIA, MD 21045-2336
(410) 740-9001
Mailing address
PO BOX 434, LISBON, MD 21765-0434
(410) 274-1401
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R151007
MD
Other
Enumeration date
06/22/2019
Last updated
06/22/2019
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