Provider Demographics
NPI:1679737761
Name:GOHEL, SHAILESH K (MD)
Entity type:Individual
Prefix:
First Name:SHAILESH
Middle Name:K
Last Name:GOHEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3733 FETTLER PARK DR
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025-2048
Mailing Address - Country:US
Mailing Address - Phone:703-670-0300
Mailing Address - Fax:703-291-5331
Practice Address - Street 1:3733 FETTLER PARK DR
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025
Practice Address - Country:US
Practice Address - Phone:703-670-0300
Practice Address - Fax:703-291-5331
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT192780208000000X
NJ25MA08429900208000000X
VA0101244499208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics