Provider Demographics
NPI:1942392212
Name:SHETH, ATUL K (MD)
Entity Type:Individual
Prefix:MR
First Name:ATUL
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:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1000
Mailing Address - Country:US
Mailing Address - Phone:661-635-2950
Mailing Address - Fax:312-533-2838
Practice Address - Street 1:1600 E BELLE TER
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-3871
Practice Address - Country:US
Practice Address - Phone:661-635-2950
Practice Address - Fax:815-663-0445
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1048-3202084P0800X
CAA466872084P0800X
IL0360783862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036078386Medicaid
IL036078386Medicaid
A94970Medicare UPIN