Individual
DR. PRABHKAR K SHETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
36 COUNTRY CLUB RD, GILFORD, NH 03249-6978
(603) 524-8020
(603) 527-0271
Mailing address
PO BOX 7392, VILLAGE WEST II, LACONIA, NH 03247-7392
(603) 524-8020
(603) 527-0271
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4969
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0103853Y0NH01
ANTHEM BLUE CROSS
NH
01
—
6090
CIGNA
NH
05
—
81183853
—
NH
Enumeration date
11/30/2005
Last updated
01/14/2014
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