MEDICARE: SAMEER B SHETTY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME99710	FL
2	207R00000X	Internal Medicine Physician	MD442241	PA
3	208M00000X	Hospitalist Physician	245676	NY
4	208M00000X	Hospitalist Physician	MD442241	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891988226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMEER B SHETTY MD

Provider Business Mailing Address
First Line	:	100 N ACADEMY AVE # MC4903
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	17822-9800
Country	:	US
Telephone Number	:	570-271-6144
Fax Number	:	570-271-6578

Provider Business Practice Location Address
First Line	:	255 ROUTE 220 HWY
Second Line	:
City	:	MUNCY
State	:	PA
Zip	:	17756-7568
Country	:	US
Telephone Number	:	570-308-2500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2007
Last Update Date	:	04/03/2025

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Directions to “ SAMEER B SHETTY MD” Practice Location

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