Provider Demographics
NPI:1407299340
Name:SHETH, ANOOP DIPAK (MD)
Entity Type:Individual
Prefix:
First Name:ANOOP
Middle Name:DIPAK
Last Name:SHETH
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 1:9360 FALLS OF NEUSE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2485
Mailing Address - Country:US
Mailing Address - Phone:919-865-7870
Mailing Address - Fax:
Practice Address - Street 1:9360 FALLS OF NEUSE RD STE 105
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2485
Practice Address - Country:US
Practice Address - Phone:919-865-7870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101273414207Q00000X
CODR.0069958207Q00000X
AZ64652207Q00000X
NC2022-02808207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine