MEDICARE: ARCHANA SHETTY 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	D0050260	MD

Other Identifiers

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

General Provider Information

NPI Number	:	1821091240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARCHANA SHETTY M.D.

Provider Business Mailing Address
First Line	:	6001 MONTROSE RD
Second Line	:	STE 211
City	:	ROCKVILLE
State	:	MD
Zip	:	20852-4872
Country	:	US
Telephone Number	:	301-468-1451
Fax Number	:	301-468-3580

Provider Business Practice Location Address
First Line	:	6430 ROCKLEDGE DR STE 300
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-1847
Country	:	US
Telephone Number	:	301-468-1451
Fax Number	:	301-468-3580

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	03/26/2019

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