Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 01073308A | IN |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 036123861 | IL |
NPI | 1053571224 |
---|---|
Provider Name | Dr. Sachin Ashok Mehta |
First Address | Detroit, MI 48278-1076 |
Second Address | Indianapolis, IN 46237-8600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 13/03/2021 |