MEDICARE: DR. PUJA K 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	207R00000X	Internal Medicine Physician	054618	GA
2	207RC0000X	Cardiovascular Disease Physician	054618	GA

General Provider Information

NPI Number	:	1881780120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PUJA K MEHTA MD

Provider Business Mailing Address
First Line	:	1462 CLIFTON RD NE, SUITE 505
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322
Country	:	US
Telephone Number	:	404-712-0281
Fax Number	:	404-727-6495

Provider Business Practice Location Address
First Line	:	1605 CHANTILLY DR NE FL 3
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-3267
Country	:	US
Telephone Number	:	404-778-2746
Fax Number	:

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	01/01/2025

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