Provider Demographics
NPI:1902859184
Name:SHETH, NIDHIR RAS (MD)
Entity type:Individual
Prefix:DR
First Name:NIDHIR
Middle Name:RAS
Last Name:SHETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:609-265-1700
Mailing Address - Fax:609-265-8146
Practice Address - Street 1:693 MAIN ST
Practice Address - Street 2:BLDG A STE 2
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048
Practice Address - Country:US
Practice Address - Phone:609-265-1700
Practice Address - Fax:609-265-8146
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07417600207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7684408OtherAETNA
NJ9105204Medicaid
H69482Medicare UPIN
NJ061429BDEMedicare ID - Type Unspecified