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General NPI Number Information
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NPI Number | 1154307247
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Entity Type | Individual
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Provider Name | MONAL A MEHTA MD
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Gender | Male
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 1525 ELM ST ELM STREET HEALTH CENTER
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City | CINCINNATI
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State | OH
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Zip | 45202-6957
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Country | US
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Telephone | 513-352-3092
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Fax | 513-352-1429
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Provider Business Mailing Address
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Address Line | 3101 BURNET AVE
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City | CINCINNATI
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State | OH
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Zip | 45229-3014
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Country | US
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Telephone | 513-357-7289
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Fax | 513-352-1429
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35065500
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License Number State | OH
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