Healthcare Provider Details

I. General information

NPI: 1740457647
Provider Name (Legal Business Name): DIPA K SHETH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2008
Last Update Date: 12/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 M ST NW SUITE 200
WASHINGTON DC
20037-1434
US

IV. Provider business mailing address

2300 M ST NW SUITE 200
WASHINGTON DC
20037-1434
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-2770
  • Fax:
Mailing address:
  • Phone: 202-741-2770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberMD040734
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: