Provider Demographics
NPI:1457353807
Name:SHETH, SHEELA E (MD)
Entity Type:Individual
Prefix:
First Name:SHEELA
Middle Name:E
Last Name:SHETH
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 1:5861 CINEMA DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1489
Mailing Address - Country:US
Mailing Address - Phone:513-248-8800
Mailing Address - Fax:513-248-8177
Practice Address - Street 1:5861 CINEMA DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1489
Practice Address - Country:US
Practice Address - Phone:513-248-8800
Practice Address - Fax:513-248-8177
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35064732S207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0919573Medicaid
OH0738773Medicare PIN
OHF55976Medicare UPIN