Individual
DR. SHAILESH MANSUKH PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4250 BETHEL RD, OLIVE BRANCH, MS 38654-8737
(901) 516-1290
(901) 516-1220
Mailing address
1211 UNION AVE STE 330, MEMPHIS, TN 38104-6655
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20654
MS
207R00000X
Internal Medicine Physician
2518
TN
208M00000X
Hospitalist Physician
20654
MS
208M00000X
Hospitalist Physician
2518
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04776524
—
MS
05
—
199447003
—
AR
01
—
4354878
BCBS
TN
01
—
P01240977
RAILROAD MEDICARE
MS
05
—
Q007100
—
TN
Enumeration date
06/12/2008
Last updated
10/30/2025
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