Provider Demographics
NPI:1851349930
Name:SHETH, MOHIT K (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHIT
Middle Name:K
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 1:4015 GATEWAY BLVD STE 2120
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8925
Mailing Address - Country:US
Mailing Address - Phone:812-842-0907
Mailing Address - Fax:812-464-4485
Practice Address - Street 1:1138 N ELM ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2715
Practice Address - Country:US
Practice Address - Phone:270-827-8811
Practice Address - Fax:270-827-1221
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY18722207RI0011X, 207RC0000X
IN01033439A207RI0011X, 207RC0000X
IL036-047093207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64187222Medicaid
10792AOtherCIGNA
IN100008770Medicaid
000000042529OtherANTHEM
IN060017293OtherRR MCR
839415POtherSIHO
128973OtherHEALTHLINK
10792AOtherCIGNA
128973OtherHEALTHLINK
KY64187222Medicaid
KY0255502Medicare PIN