Healthcare Provider Details

I. General information

NPI: 1366777682
Provider Name (Legal Business Name): SNEHA SHETH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2009
Last Update Date: 02/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7556 TEAGUE RD SUITE 210
HANOVER MD
21076-1213
US

IV. Provider business mailing address

1111 BENFIELD BLVD SUITE 200
MILLERSVILLE MD
21108-3002
US

V. Phone/Fax

Practice location:
  • Phone: 410-551-0499
  • Fax: 410-799-9070
Mailing address:
  • Phone: 410-729-5100
  • Fax: 443-679-1382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2620311
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0079707
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: