Healthcare Provider Details

I. General information

NPI: 1609801893
Provider Name (Legal Business Name): PIYUSH N. SHETH M.D., F.A.C.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 GLESSNER AVE FL MOB5
MANSFIELD OH
44903-2269
US

IV. Provider business mailing address

335 GLESSNER AVE FL MOB5
MANSFIELD OH
44903-2269
US

V. Phone/Fax

Practice location:
  • Phone: 419-522-2833
  • Fax: 419-524-1619
Mailing address:
  • Phone: 419-522-2833
  • Fax: 419-524-1619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35070614
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: