Provider Demographics
NPI:1447253687
Name:ADYA, SHWETA N (MD)
Entity type:Individual
Prefix:
First Name:SHWETA
Middle Name:N
Last Name:ADYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BPX 639353
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-9353
Mailing Address - Country:US
Mailing Address - Phone:812-537-8241
Mailing Address - Fax:812-537-1041
Practice Address - Street 1:3501 N MACARTHUR BLVD STE 330
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3611
Practice Address - Country:US
Practice Address - Phone:812-926-0793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2019-07-17
Deactivation Date:2006-03-29
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
IN01057058A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200415750Medicaid
IN170960CMedicare PIN
INH82625Medicare UPIN