Provider Demographics
NPI:1962726489
Name:KHETARPAL, SHILPI (MD)
Entity type:Individual
Prefix:DR
First Name:SHILPI
Middle Name:
Last Name:KHETARPAL
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 1:9500 EUCLID AVE # A61
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:330-806-1312
Mailing Address - Fax:216-636-0435
Practice Address - Street 1:9500 EUCLID AVE # DESKA61
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-8904
Practice Address - Fax:216-636-0436
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35120393207N00000X
MA261572207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology