Provider Demographics
NPI:1346521218
Name:SHET, NINAD P (MD)
Entity Type:Individual
Prefix:
First Name:NINAD
Middle Name:P
Last Name:SHET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843
Mailing Address - Street 2:
Mailing Address - City:PORTALES
Mailing Address - State:NM
Mailing Address - Zip Code:88130-0843
Mailing Address - Country:US
Mailing Address - Phone:575-623-3255
Mailing Address - Fax:575-625-9901
Practice Address - Street 1:1511 SOUTH GRAND
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88203
Practice Address - Country:US
Practice Address - Phone:575-623-3255
Practice Address - Fax:575-625-9901
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2014-0640207R00000X
TXBP10041385207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine