Healthcare Provider Details

I. General information

NPI: 1083100416
Provider Name (Legal Business Name): SARAH SNEH MEHTA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2018
Last Update Date: 07/05/2021
Certification Date: 07/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PL CB8116
SAINT LOUIS MO
63110-1002
US

IV. Provider business mailing address

1 CHILDRENS PLACE CB8116
SAINT LOUIS MO
63110
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-6124
  • Fax: 833-463-6898
Mailing address:
  • Phone: 314-454-6124
  • Fax: 833-463-6898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2021014486
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2021025593
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: