Healthcare Provider Details

I. General information

NPI: 1487911467
Provider Name (Legal Business Name): NIMA CHATUR SHETH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2012
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 WISCONSIN AVE NW
WASHINGTON DC
20007-2265
US

IV. Provider business mailing address

2115 WISCONSIN AVE NW
WASHINGTON D.C. DC
20007
US

V. Phone/Fax

Practice location:
  • Phone: 202-944-5400
  • Fax:
Mailing address:
  • Phone: 202-944-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD043983
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: