Provider Demographics
NPI:1285625194
Name:SHETH, RAMONA S (MD,)
Entity type:Individual
Prefix:DR
First Name:RAMONA
Middle Name:S
Last Name:SHETH
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 ROBBINS AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-2468
Mailing Address - Country:US
Mailing Address - Phone:330-652-7973
Mailing Address - Fax:330-652-7876
Practice Address - Street 1:940 ROBBINS AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-2468
Practice Address - Country:US
Practice Address - Phone:330-652-7973
Practice Address - Fax:330-652-7876
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35079669207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000179630OtherUNISON
OH311513392027OtherCARESOURCE
OH2431149Medicaid
OH450264OtherWELLCARE
OH000000229715OtherANTHEM
OH000000557944OtherANTHEM
OH341195211028OtherCARESOURCE
OH7613366OtherAETNA
OH8503768OtherCIGNA
OH311513392027OtherCARESOURCE
OH450264OtherWELLCARE
OH4105252Medicare PIN
OH000000229715OtherANTHEM
OH4105251Medicare PIN