Individual
DR. SHRUTI DATTA
Active
Individual
DR. SHRUTI DATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
255593
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
255593
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
55592
MN
2084P0800X
Psychiatry Physician
106218
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03299878
—
NY
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
05/30/2007
Last updated
12/15/2021
Update your record
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