MEDICARE: DHARMESH 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	35121792	OH

General Provider Information

NPI Number	:	1629381363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DHARMESH MEHTA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 931596
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-1724
Country	:	US
Telephone Number	:	440-946-8300
Fax Number	:	440-946-8327

Provider Business Practice Location Address
First Line	:	6555 WILSON MILLS RD STE 103D
Second Line	:
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-3435
Country	:	US
Telephone Number	:	440-449-1540
Fax Number	:	440-460-2833

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

Provider Enumeration Date	:	07/22/2010
Last Update Date	:	04/02/2025

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