=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275876641
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARIFF A. MEHTER M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2013
-----------------------------------------------------
Last Update Date | 03/18/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 805 CENTRAL AVE STE 150 RISK MANAGEMENT,/EHS, TWO CENTENNIAL PLAZA
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45202-5756
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-352-1990
-----------------------------------------------------
Fax | 513-352-1995
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3835 NOTTINGHAM CT
-----------------------------------------------------
City | CLEVES
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45002-2348
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-941-1786
-----------------------------------------------------
Fax | 513-941-1786
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2083X0100X
-----------------------------------------------------
Taxonomy Name | Occupational Medicine Physician
-----------------------------------------------------
License Number | 35072986
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------