Healthcare Provider Details

I. General information

NPI: 1013392067
Provider Name (Legal Business Name): KABIR MEHTA M.B.B.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2015
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 E 28TH ST STE 460
MINNEAPOLIS MN
55407-1139
US

IV. Provider business mailing address

200 MEDICAL CENTER DR
HAZARD KY
41701-9466
US

V. Phone/Fax

Practice location:
  • Phone: 612-863-7770
  • Fax: 612-863-7772
Mailing address:
  • Phone: 606-487-7510
  • Fax: 606-439-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number56808
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number26768
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number62584
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: