Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 38517 | TN |
N | 2081P2900X | Pain Medicine | 38517 | TN |
NPI | 1174533772 |
---|---|
Provider Name | Hemal V Mehta |
First Address | Murfreesboro, TN 37130-2034 |
Second Address | Murfreesboro, TN 37130-2034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 09/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1511689 | (05) | TN |
E04076 | (02) |