Healthcare Provider Details

I. General information

NPI: 1073192217
Provider Name (Legal Business Name): SHWETA SUNIL KAMAT MASHNI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 NICHOLASVILLE RD STE 601A
LEXINGTON KY
40503-1498
US

IV. Provider business mailing address

1720 NICHOLASVILLE RD STE 601A
LEXINGTON KY
40503-1498
US

V. Phone/Fax

Practice location:
  • Phone: 859-639-0905
  • Fax: 859-639-0906
Mailing address:
  • Phone: 859-639-0905
  • Fax: 859-639-0906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number60349
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: