Healthcare Provider Details

I. General information

NPI: 1265403752
Provider Name (Legal Business Name): KIRAN MEHTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 BABCOCK BLVD DEPT OF RADIATION ONCOLOGY
PITTSBURGH PA
15237-5815
US

IV. Provider business mailing address

9100 BABCOCK BLVD DEPT OF RADIATION ONCOLOGY
PITTSBURGH PA
15237-5815
US

V. Phone/Fax

Practice location:
  • Phone: 412-367-6454
  • Fax: 412-367-6913
Mailing address:
  • Phone: 412-367-6454
  • Fax: 412-367-6913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD052985L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: