Provider Demographics
NPI:1811397722
Name:SHETH, PRIYA (OD)
Entity Type:Individual
Prefix:DR
First Name:PRIYA
Middle Name:
Last Name:SHETH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8811 BLAKENEY PROFESSIONAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-6599
Mailing Address - Country:US
Mailing Address - Phone:704-926-3937
Mailing Address - Fax:704-926-3938
Practice Address - Street 1:8811 BLAKENEY PROFESSIONAL DR STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-6599
Practice Address - Country:US
Practice Address - Phone:704-926-3937
Practice Address - Fax:704-926-3938
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2401152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist