Provider Demographics
NPI:1730321852
Name:SHETH, ASHIKA (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHIKA
Middle Name:
Last Name:SHETH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1538 13TH AVE
Mailing Address - Street 2:SUITE B300
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1956
Mailing Address - Country:US
Mailing Address - Phone:706-321-9300
Mailing Address - Fax:
Practice Address - Street 1:1538 13TH AVE
Practice Address - Street 2:SUITE B300
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1956
Practice Address - Country:US
Practice Address - Phone:706-321-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-03
Last Update Date:2009-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005559363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical