Provider Demographics
NPI:1831283167
Name:SHETH, SHRUTI N (MD, MSC)
Entity Type:Individual
Prefix:
First Name:SHRUTI
Middle Name:N
Last Name:SHETH
Suffix:
Gender:F
Credentials:MD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-5752
Mailing Address - Country:US
Mailing Address - Phone:650-388-6085
Mailing Address - Fax:
Practice Address - Street 1:1003 OLIVE ST
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-5752
Practice Address - Country:US
Practice Address - Phone:650-388-6085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221283207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology