Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 01053906A | IN |
N | 207Q00000X | Family Doctor | 058507 | GA |
N | 207Q00000X | Family Doctor | 36086 | KY |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 01053906A | IN |
NPI | 1003845488 |
---|---|
Provider Name | Jayesh Sheth |
First Address | Sellersburg, IN 47172-1801 |
Second Address | Sellersburg, IN 47172-1801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 01/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200326370 | (05) | IN |
64036304 | (05) | KY |
H32174 | (02) | |
P00422955 | RAILROAD MEDICARE (01) |