Provider Demographics
NPI:1821340340
Name:SHETH, NUTAN NITIN (RPH)
Entity Type:Individual
Prefix:MS
First Name:NUTAN
Middle Name:NITIN
Last Name:SHETH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 WESTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-1834
Mailing Address - Country:US
Mailing Address - Phone:919-851-5247
Mailing Address - Fax:919-859-4357
Practice Address - Street 1:4500 WESTERN BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-1834
Practice Address - Country:US
Practice Address - Phone:919-851-5247
Practice Address - Fax:919-859-4357
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17123183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist