Provider Demographics
NPI:1841221009
Name:SHETH, DARSHANA (MD)
Entity Type:Individual
Prefix:
First Name:DARSHANA
Middle Name:
Last Name:SHETH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6823 HIGHWAY 311
Mailing Address - Street 2:
Mailing Address - City:SELLERSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47172-1801
Mailing Address - Country:US
Mailing Address - Phone:812-246-9809
Mailing Address - Fax:
Practice Address - Street 1:6823 HIGHWAY 311
Practice Address - Street 2:
Practice Address - City:SELLERSBURG
Practice Address - State:IN
Practice Address - Zip Code:47172-1801
Practice Address - Country:US
Practice Address - Phone:812-246-9809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056788A207Q00000X
KY37178207Q00000X
GA058642207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200410540Medicaid
KY64054844Medicaid
50014110OtherPASSPORT
KY64054844Medicaid
GA511I080456Medicare PIN
IN200410540Medicaid