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1982607636

NPI Code Detail

MEDICARE: SARVOTHAM SHETTY MD

MEDICARE: SARVOTHAM SHETTY 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
1	207R00000X	Internal Medicine Physician	MD063217L	PA
2	208M00000X	Hospitalist Physician	MD063217L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000966418	OTHER	PA	HIGHMARK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982607636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARVOTHAM SHETTY MD

Provider Business Mailing Address
First Line	:	532 W PITTSBURGH ST
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-2239
Country	:	US
Telephone Number	:	724-850-6957
Fax Number	:	724-830-8613

Provider Business Practice Location Address
First Line	:	532 W PITTSBURGH ST
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-2239
Country	:	US
Telephone Number	:	724-850-6957
Fax Number	:	724-830-8613

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

Provider Enumeration Date	:	05/25/2005
Last Update Date	:	09/09/2016

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Directions to “ SARVOTHAM SHETTY MD” Practice Location

Language	Start Address	Practice Location

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