MEDICARE: DR. BINA MEHTA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	35072527M	OH
2	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	35-072527	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9338635	OTHER	OH	PARTNERS PHYSICIAN GROUP MEDICARE GROUP #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1841239274	OTHER	OH	PARTNERS PHYSICIAN GROUP TYPE 2 NPI #

General Provider Information

NPI Number	:	1831193606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BINA MEHTA MD

Provider Business Mailing Address
First Line	:	307 W MAIN ST
Second Line	:	STE C
City	:	KENT
State	:	OH
Zip	:	44240
Country	:	US
Telephone Number	:	330-677-3628
Fax Number	:	330-677-3626

Provider Business Practice Location Address
First Line	:	307 W MAIN ST
Second Line	:	STE C
City	:	KENT
State	:	OH
Zip	:	44240
Country	:	US
Telephone Number	:	330-677-3628
Fax Number	:	330-677-3626

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	02/10/2016

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Directions to “ DR. BINA MEHTA MD” Practice Location

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