Provider Demographics
NPI:1902197403
Name:SHAH, SWETA S (MD)
Entity Type:Individual
Prefix:DR
First Name:SWETA
Middle Name:S
Last Name:SHAH
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 1:3225 DANNY PARK STE 100
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-5751
Mailing Address - Country:US
Mailing Address - Phone:504-889-0550
Mailing Address - Fax:504-889-0582
Practice Address - Street 1:3225 DANNY PARK STE 100
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-5751
Practice Address - Country:US
Practice Address - Phone:504-889-0550
Practice Address - Fax:504-889-0582
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA204807207K00000X, 207K00000X, 2080P0201X, 174400000X
TXN27952080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2164716Medicaid
LA2164716Medicaid