Healthcare Provider Details

I. General information

NPI: 1184685877
Provider Name (Legal Business Name): PARTHIV J SHETH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 05/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9228 GEORGE WASHINGTON MEMORIAL HWY
GLOUCESTER VA
23061-4162
US

IV. Provider business mailing address

9228 GEORGE WASHINGTON MEMORIAL HWY P.O. BOX 2468
GLOUCESTER VA
23061-4162
US

V. Phone/Fax

Practice location:
  • Phone: 804-693-5068
  • Fax: 804-693-7407
Mailing address:
  • Phone: 804-693-5068
  • Fax: 804-693-7407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number0101226872
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101226872
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: