Healthcare Provider Details

I. General information

NPI: 1386835841
Provider Name (Legal Business Name): SOHAM GITESHKUMAR SHETH M.B.B.S.,M.P.H
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 BAYLOR CT STE 100
CHESAPEAKE VA
23320-3690
US

IV. Provider business mailing address

501 BAYLOR CT STE 100
CHESAPEAKE VA
23320-3690
US

V. Phone/Fax

Practice location:
  • Phone: 757-991-0190
  • Fax: 757-991-0191
Mailing address:
  • Phone: 757-991-0190
  • Fax: 757-991-0191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number0101243431
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number0101243431
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301082474
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0101243431
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number0101243431
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: