Healthcare Provider Details

I. General information

NPI: 1427072834
Provider Name (Legal Business Name): USHA MEHTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 11/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13301 MILES AVE
CLEVELAND OH
44105-5521
US

IV. Provider business mailing address

13301 MILES AVE
CLEVELAND OH
44105-5521
US

V. Phone/Fax

Practice location:
  • Phone: 216-751-3100
  • Fax: 216-751-2480
Mailing address:
  • Phone: 216-751-3100
  • Fax: 216-751-2480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35076657
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: