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NPI Code Detail

MEDICARE: MANISH R SHETH MD

MEDICARE: MANISH R SHETH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0003XHematology & Oncology Physician084487OH
2207RH0003XHematology & Oncology Physician35084487OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205832730
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANISH R SHETH MD
Provider Business Mailing Address
First Line : 6680 POE AVE STE 200
Second Line :
City : DAYTON
State : OH
Zip : 45414-2855
Country : US
Telephone Number : 937-280-8400
Fax Number : 937-280-8373
Provider Business Practice Location Address
First Line : 3120 GOVERNORS PLACE BLVD
Second Line :
City : KETTERING
State : OH
Zip : 45409-1328
Country : US
Telephone Number : 937-293-1622
Fax Number : 937-245-6308
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 01/07/2022

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