Healthcare Provider Details

I. General information

NPI: 1811177660
Provider Name (Legal Business Name): MISS NOOPUR MEHTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2007
Last Update Date: 12/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 23RD ST NW
WASHINGTON DC
20037
US

IV. Provider business mailing address

2021 K ST NW STE 408
WASHINGTON DC
20006-1003
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-3387
  • Fax: 202-741-3570
Mailing address:
  • Phone: 202-741-3387
  • Fax: 202-741-3570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number005218
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License NumberA000051
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: