Individual
SHRENA PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
295 CHIPETA WAY, SALT LAKE CITY, UT 84108-1287
(801) 581-7052
Mailing address
875 DONNER WAY APT 1004, SALT LAKE CITY, UT 84108-4100
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
6246246-1205
UT
2080N0001X
Neonatal-Perinatal Medicine Physician
066881
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003116750A
—
GA
01
—
01470758
AMERIGROUP
GA
01
—
0833146
CIGNA
GA
01
—
12001050
AETNA
GA
01
—
3409438
UNITED HEALTHCARE
GA
01
—
650683
WELLCARE
GA
Enumeration date
05/15/2008
Last updated
04/10/2012
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