Healthcare Provider Details

I. General information

NPI: 1104890185
Provider Name (Legal Business Name): TULSI KIKU MEHTA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW SUITE 2A38
WASHINGTON DC
20010-2976
US

IV. Provider business mailing address

110 IRVING ST NW SUITE 2A-38
WASHINGTON DC
20010-2976
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-6034
  • Fax:
Mailing address:
  • Phone: 202-877-6034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD035417
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: