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NPI Code Detail

MEDICARE: MR. VINAY K MEHTA M.D.F.A.C.S.

MEDICARE: MR. VINAY K MEHTA M.D.F.A.C.S.
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
1208600000XSurgery Physician036047339IL

General Provider Information

NPI Number : 1538149430
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VINAY K MEHTA M.D.F.A.C.S.
Provider Business Mailing Address
First Line : PO BOX 1105
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46206-1105
Country : US
Telephone Number : 618-252-8625
Fax Number : 618-252-2540
Provider Business Practice Location Address
First Line : 117 E CLARK ST
Second Line :
City : HARRISBURG
State : IL
Zip : 62946-2702
Country : US
Telephone Number : 618-252-8625
Fax Number : 618-252-2540
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 01/23/2014

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