Healthcare Provider Details

I. General information

NPI: 1184114837
Provider Name (Legal Business Name): PARTH PRADIP SHETH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 PEACHTREE RD NW
ATLANTA GA
30309-1281
US

IV. Provider business mailing address

UVA NEUROLOGY DEPARTMENT 1221 LEE ST, 4TH FLOOR
CHARLOTTESVILLE VA
22903
US

V. Phone/Fax

Practice location:
  • Phone: 470-788-1010
  • Fax:
Mailing address:
  • Phone: 434-924-2706
  • Fax: 803-545-6051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberLL52352
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0101274059
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number95936
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: