MEDICARE: PRANAV B. SHETH M. D.

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
1	207N00000X	Dermatology Physician	35.066315	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	93260	OTHER	OH	W/C
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518904838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRANAV B. SHETH M. D.

Provider Business Mailing Address
First Line	:	7249 LIBERTY WAY STE 100
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-1704
Country	:	US
Telephone Number	:	513-770-3263
Fax Number	:

Provider Business Practice Location Address
First Line	:	7249 LIBERTY WAY STE 100
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-1704
Country	:	US
Telephone Number	:	513-770-3263
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	12/12/2024

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