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General NPI Number Information
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NPI Number | 1427037357
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Entity Type | Individual
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Provider Name | DITHI A SHETTY MD
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Gender | Female
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 1200 N BEAVER ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-3118
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Country | US
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Telephone | 928-773-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 110 COACHMAN PLACE WEST
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City | SYOSSET
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State | NY
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Zip | 11791
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Country | US
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Telephone | 631-271-9151
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Fax | 631-271-9155
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 2024-01959
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 76890
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 2243611
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 84182
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 01089055A
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License Number State | IN
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