Provider Demographics
NPI:1164422259
Name:SHVETS, VIKTORIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:VIKTORIA
Middle Name:A
Last Name:SHVETS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VIKTORIA
Other - Middle Name:A
Other - Last Name:SHVETS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:226 HAGGETTS POND RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-4229
Mailing Address - Country:US
Mailing Address - Phone:978-681-5293
Mailing Address - Fax:
Practice Address - Street 1:21 HIGHLAND AVE
Practice Address - Street 2:ANNAJAQUES HOSPITAL
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3872
Practice Address - Country:US
Practice Address - Phone:978-463-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223002207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2088282Medicaid
MA2088282Medicaid
MNA37521Medicare ID - Type Unspecified