Provider Demographics
NPI:1245974773
Name:SHETH, GAURAVI (RPH)
Entity type:Individual
Prefix:
First Name:GAURAVI
Middle Name:
Last Name:SHETH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 MASTERS CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-9451
Mailing Address - Country:US
Mailing Address - Phone:757-685-7699
Mailing Address - Fax:
Practice Address - Street 1:1313 MASTERS CT
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-9451
Practice Address - Country:US
Practice Address - Phone:757-685-7699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202208583183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist