Individual
KETAN K SHETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1345 UNITY PL, SUITE 145A, LAFAYETTE, IN 47905-5760
(765) 446-5040
(765) 446-5041
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
01040024A
IN
208000000X
Pediatrics Physician
01040024A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100196140
—
IN
Enumeration date
03/16/2006
Last updated
07/08/2024
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