Healthcare Provider Details

I. General information

NPI: 1851349930
Provider Name (Legal Business Name): MOHIT K SHETH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 04/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1138 N ELM ST
HENDERSON KY
42420-2715
US

IV. Provider business mailing address

4015 GATEWAY BLVD STE 2120
NEWBURGH IN
47630-8925
US

V. Phone/Fax

Practice location:
  • Phone: 270-827-8811
  • Fax: 270-827-1221
Mailing address:
  • Phone: 812-842-0907
  • Fax: 812-464-4485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number18722
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number01033439A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036-047093
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number18722
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number01033439A
License Number StateIN
# 6
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number036-047093
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: