Shetty, Mahadevan
Shetty, Mahadevan is an individual health care provider with primary practice located at 385 Main St S, C/O Nvra Union Square Bldg#1, Southbury CT 06488-4240. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Shetty, Mahadevan can be contacted via phone (203) 264-7999.Contact Information
Primary practice address
385 Main St S, C/O Nvra Union Square Bldg#1
Southbury CT 06488-4240
Phone: (203) 264-7999
Fax: (203) 264-7477
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | 020421 | Connecticut |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 020421 | Connecticut |
| Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X | 020421 | Connecticut |
Profile Details
| NPI number | 1386678290 |
|---|---|
| LBN Legal business name | Shetty, Mahadevan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2006 |
| Last updated | May 18th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386678290 | NPPES |
| Connecticut | MEDICAID | 001204213 |
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