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General NPI Number Information
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NPI Number | 1407993868
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Entity Type | Individual
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Provider Name | NUPUR MEHTA M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 02/14/2024
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Provider Practice Location Address
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Address Line | 600 SUPERIOR AVENUE EAST FIFTH/THIRD BUILDING SUITE 1300
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City | CLEVELAND
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State | OH
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Zip | 44114
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Country | US
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Telephone | 234-200-0854
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Fax |
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Provider Business Mailing Address
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Address Line | 143 BOARDMAN CANFIELD RD STE 359
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City | BOARDMAN
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State | OH
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Zip | 44512-4804
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Country | US
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Telephone | 234-200-0854
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Fax |
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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 | 0101266382
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License Number State | VA
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