Individual
DAYANANDA MULUR SHETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9831 DEL WEBB PARKWAY, #2305, JACKSONVILLE, FL 32256-5807
(904) 519-6575
(904) 519-6575
Mailing address
9831 DEL WEBB PARKWAY, #2305, JACKSONVILLE, FL 32256-5807
(904) 519-6575
(904) 519-6575
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
01026607A
IN
207Y00000X
Otolaryngology Physician
Primary
ME86870
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100141560A
—
IN
01
—
49504600121
AMA
—
01
—
91107713
BCBS
IN
Enumeration date
12/15/2006
Last updated
07/08/2007
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