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General NPI Number Information
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NPI Number | 1235307380
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Entity Type | Organization
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Legal Business Name | VIRENDRA S MEHTA MD FRCS PC
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 04/29/2020
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Provider Practice Location Address
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Address Line | 10000 TELEGRAPH RD
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City | TAYLOR
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State | MI
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Zip | 48180-3330
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Country | US
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Telephone | 248-842-7913
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Fax | 313-295-5315
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Provider Business Mailing Address
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Address Line | 47493 BLUE HERON CT
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City | NORTHVILLE
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State | MI
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Zip | 48168-8823
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Country | US
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Telephone | 248-842-7913
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Fax | 586-649-7391
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Authorized Official
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Title or Position | PRESIDENT
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Name | VIRENDRA SINHA MEHTA
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Credential | MD
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Telephone | 248-842-7913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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