MEDICARE: DR. DARSHAN HEMENDRA MEHTA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	224812	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114992468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARSHAN HEMENDRA MEHTA M.D.

Provider Business Mailing Address
First Line	:	36 TOWER ST
Second Line	:
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-3705
Country	:	US
Telephone Number	:	617-325-1471
Fax Number	:	617-643-6077

Provider Business Practice Location Address
First Line	:	151 MERRIMAC ST
Second Line	:	4TH FLOOR
City	:	BOSTON
State	:	MA
Zip	:	02114-4714
Country	:	US
Telephone Number	:	617-643-6046
Fax Number	:	617-643-6077

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	10/29/2008

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