Provider Demographics
NPI:1760452361
Name:SHETH, MALAY (MD)
Entity Type:Individual
Prefix:
First Name:MALAY
Middle Name:
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 1:104 WELLNESS WAY
Mailing Address - Street 2:BLDG 2
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-9706
Mailing Address - Country:US
Mailing Address - Phone:724-225-3640
Mailing Address - Fax:724-225-3093
Practice Address - Street 1:104 WELLNESS WAY
Practice Address - Street 2:BLDG 2
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-9706
Practice Address - Country:US
Practice Address - Phone:724-225-3640
Practice Address - Fax:724-225-3093
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045363L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F33575Medicare UPIN
050745Medicare ID - Type Unspecified