MEDICARE: GAURAV MEHTA MD

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	207Q00000X	Family Medicine Physician	125060123	IL
2	207QB0002X	Obesity Medicine (Family Medicine) Physician	0101285584	VA
3	207Q00000X	Family Medicine Physician	C1-0011080	DE
4	207Q00000X	Family Medicine Physician	0101285584	VA

General Provider Information

NPI Number	:	1588978118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAURAV MEHTA MD

Provider Business Mailing Address
First Line	:	224- D CORNWALL STREET, NW, SUITE 403
Second Line	:
City	:	LEESBURG
State	:	VA
Zip	:	20176-2704
Country	:	US
Telephone Number	:	703-737-6010
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 JOSEPH SIEWICK DR STE 106
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-1737
Country	:	US
Telephone Number	:	571-724-4400
Fax Number	:

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

Provider Enumeration Date	:	08/06/2010
Last Update Date	:	01/08/2026

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Directions to “ GAURAV MEHTA MD” Practice Location

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