Provider Demographics
NPI:1205816501
Name:DR. YOGESH O. SHETH, MD
Entity Type:Organization
Organization Name:DR. YOGESH O. SHETH, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNTS
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:STREETS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-898-1723
Mailing Address - Street 1:940 ROBBINS AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-2442
Mailing Address - Country:US
Mailing Address - Phone:330-652-7973
Mailing Address - Fax:330-652-7876
Practice Address - Street 1:940 ROBBINS AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-2442
Practice Address - Country:US
Practice Address - Phone:330-652-7973
Practice Address - Fax:330-652-7876
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:S & J MED., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-20
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH110220860OtherRAILROAD MEDICARE
000000128444OtherANTHEM
OH112531851OtherRAILROAD MEDICARE
OH0290242Medicaid
OH000000121268OtherANTHEM
000000128444OtherANTHEM
OH=========-00OtherWORKERS COMP
OH110220860OtherRAILROAD MEDICARE
OH112531851OtherRAILROAD MEDICARE