Individual
JAGADEESHA N SHETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 IRMC DR, SUITE160, INDIANA, PA 15701-3674
(724) 465-2676
(724) 349-1830
Mailing address
120 IRMC DR, SUITE160, INDIANA, PA 15701-3674
(724) 465-2676
(724) 349-1830
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD064511L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016948000002
—
PA
01
—
CI1160
RAILROAD MEDICARE
PA
Enumeration date
03/25/2006
Last updated
04/25/2016
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