Provider Demographics
NPI:1952689200
Name:MAHESHWARI, SHWETA NAVNEET (DO)
Entity Type:Individual
Prefix:DR
First Name:SHWETA
Middle Name:NAVNEET
Last Name:MAHESHWARI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SHWETA
Other - Middle Name:
Other - Last Name:MAHESHWARI REDDY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:4905 COURTNEY DR
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-1427
Mailing Address - Country:US
Mailing Address - Phone:404-366-3636
Mailing Address - Fax:404-362-0808
Practice Address - Street 1:4905 COURTNEY DR
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-1427
Practice Address - Country:US
Practice Address - Phone:404-366-3636
Practice Address - Fax:404-362-0808
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.011361208000000X
GA078830208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0104982Medicaid
OH0105065OtherGROUP MEDICAID
OH0104982Medicaid