Healthcare Provider Details

I. General information

NPI: 1508270745
Provider Name (Legal Business Name): MEHUL DAULAT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 RODEO RD
SANTA FE NM
87507-4830
US

IV. Provider business mailing address

4001 RODEO RD
SANTA FE NM
87507-4830
US

V. Phone/Fax

Practice location:
  • Phone: 505-780-8381
  • Fax: 505-467-8521
Mailing address:
  • Phone: 505-780-8381
  • Fax: 505-467-8521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberDO180625
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA-2060-17
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5347
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: